Electronic patient sitter management system and method for implementing

ABSTRACT

An electronic sitter management system coupled to patient surveillance network having a plurality of video cameras, each camera transmitting a stream of surveillance video of a respective patient room. The sitter management system includes at least one sitter management device and a plurality of sitter devices. Each device being assigned a plurality of patient rooms and capable of receiving a plurality of streams of surveillance video for the corresponding plurality of patient rooms and simultaneously displaying a plurality of video images of the corresponding plurality of patient rooms. Each device is also capable of transmitting sitter device availability information to the sitter management device. The sitter management device being capable of recognizing a sitter device being unavailable and reassigning the plurality of patient rooms previously assigned to the unavailable device to other of the plurality of sitter devices that are available.

The present application is related to and claims priority from thefollowing U.S. patent applications: U.S. Provisional Patent ApplicationNo. 61/577,634, entitled Electronic Patient Sitter Management System andMethod for Implementing and U.S. Provisional Patent Application No.61/709,129, entitled Electronic Patient Sitter Management System andMethod for Implementing filed Oct. 2, 2012, which are assigned to theassignee of the present invention. The above identified applications areincorporated by reference herein in their entirety.

BACKGROUND OF THE INVENTION

The present invention relates generally to monitoring patientsurveillance video using a sitter's patient monitoring device. Moreparticularly, the present invention relates to an electronic patientsitter management system, and method and software program product formanaging a plurality of sitter's patient monitoring devices formonitoring real time surveillance patient room video based on theavailability of the sitter's patient monitoring devices to theelectronic patient sitter management system.

At times, patients and/or residents in a heath care facility (HCF),which may be a hospital, convalescent facility, nursing home, long termcare facility, a rehabilitation facility, or the like, will need managedassistance that does not rise to the level of that typically offered bya HCF professional, i.e., a doctor, counselor, nurse, or even a nurseaide, however, the patient must be continuously monitored for conditionsthat might indicate the immediate need for intervention by a HCFprofessional. Such situations include, but are not limited to, patient'sthat are in a demented, depressed, impaired or incapacitated mentalstate in which the patient can not be trusted to make cognitivedecisions concerning her own welfare, best interest or safety. Examplesinclude, patients under sedation or other medications that reduce thecognitive abilities or patient's motor skills, or under or recoveringfrom any medical procedure or diagnostic procedure utilizing suchmedications, patients recovering from surgery, a general anesthesia (orsome local anesthetics that might impair the patient's mental capacityor motor skills), suicidal or deeply depressed patients, patients in theinitial or critical stages of substance abuse treatment where sobrietymust be independently verified and other similar situations.

In the prior art, these types of patients were handled in one of twoways: remote monitoring of patients at a predesigned HCF station, suchas a nurse station, by HCF professionals on duty at that station and bya sitter stationed with the patient, typically in the same room as thepatient (a local sitter).

Monitoring patients by HCF professionals on duty at a predesigned HCFstation is described in U.S. Pat. No. 7,477,285 to Johnson, entitledNon-Intrusive Data Transmission Network for Use in an EnterpriseFacility and Method for Implementing, which is assigned to the assigneeof the present invention, and to a lesser extent each of U.S. patentapplications: Ser. No. 12/589,654 entitled System and Method forPredicting Patient Falls, 12589654 System and Method for DocumentingPatient Procedures, serial no.: 12804774 entitled System and Method forUsing a Video Monitoring System to Prevent and Manage Decubitus Ulcersin Patients and Ser. No. 61/513,523 entitled Noise Correcting PatientFall Risk State System and Method for Predicting Patient Falls, eachassigned to the assignee of the present invention and all of which areincorporated herein by reference in their entireties. These patientmonitoring systems involve implementing a patient surveillance system inwhich a surveillance video camera is strategically positioned inpatients' rooms and which is connected to a surveillance network. Thesurveillance network is further connected to a nurse monitoring devicelocated at the predesigned HCF station. FIG. 1 illustrates a view fromimage 100 of such a monitoring device. Notice surveillance image 100shows the real time surveillance video images a plurality of patientrooms, typically all of the patient rooms under the charge of thatparticular HCF station. Surveillance image 100 shows patient rooms 300through 318 under the charge of the HCF professionals assigned to thatparticular HCF station. Optimally, the nurse monitoring device willallow HCF professionals to repopulate, reorganize and resize theindividual video frames corresponding to the respective patient rooms.In so doing, image frames corresponding to patients requiring moreattention, such as those designated for sitter services, can be situatedto more prominent positions within surveillance image 100, such as tothe upper image frame rows, enlarged, enhanced or otherwise visuallydesignated as being selected for special sitter service from theattending HCF professionals at the particular HCF station.

While monitoring patients by HCF professionals on duty at a predesignedHCF station has certain advantages to other patient monitoringstrategies (i.e., the local sitter option), it is extremely expensivefor the HCF to devote one or more skilled HCF professionals to mundanesitter duties. Moreover, because the intent of sitter services is toprovide uninterrupted monitoring to patients in need of that service,having charge skilled HCF professionals such as nurses performing sitterservices is problematic because in critical situations theseprofessional often leave their monitoring duties. For instance, the HCFprofessionals on duty may be required to perform more immediate tasksinvolving other patients, such as personally attending to patients intheir respective patient rooms, thereby leaving other sitter patientsunmonitored, sometimes for extended periods of time. Additionally, eventhough the predesigned HCF stations are centrally located to thepatients' rooms under the care of that station, HCF professionals may berequired to traverse long distances or through multiple facilitycorridors in order to reach a sitter patient needing assistance.Finally, another problem with using a skilled HCF professional forsitter responsibilities is that of attention to the monitor. Monitoringsurveillance video can be extremely monotonous. Skilled HCFprofessionals often feel underutilized in sitter monitoring roles andbecome complacent, and often attempt to multitask to their other dutiesat the expense of the sitter patients.

Consequently, even though patient monitoring systems of the typediscussed in the aforementioned specifications are importantadvancements in patient care and safety, they are generally notpreferred over the use of local sitters, for the reasons given above.Most HCFs have reverted to designated patient-sitter arrangements, suchas the local sitter option.

Here it should be mentioned that typically, a sitter of the typeutilized in the local sitter option, has three primary functions:monitor patient under the sitter's care for any action that mightindicate a sitter response is needed; respond to the patient; and alerta skilled HCF professional if the sitter response is inadequate or ifthe patient action reflects a need for intervention by a skilled HCFprofessional. Typically, the maximum response authorized by a sitter toa patient is to verbally reassure the patient of her surroundings, or towarn the patient that her actions may be dangerous, harmful or otherwisecontrary to the patient orders. If any other response is necessary, thesitter must immediately alert a skilled HCF professional, typically bycalling a nurse to the patient's room. Hence, it is the sitter'sresponsibility to take a position in the patient room, visually monitorthat patient and, using the “nurse call button” or similar device, alerta skilled HCF professional if the patient situation dictates. In sodoing, the HCF can assign sitter duties to relatively unskilledpersonnel and not the more skilled and rigorously trained skilled HCFprofessional staff. Hence, although the overall cost of sitting serviceto the HCF may not decrease appreciably, at least the skilled HCFprofessional is freed from sitter responsibilities to do more importantwork, and, patients needing sitting services are monitoringcontinuously, irrespective of the workload of the skilled HCFprofessional staff. Other shortcomings of the local sitter option arethat the flex-sitter must be available to take shifts with relativelyshort notice since the sitter workload for a HCF may vary widely fromone shift to the next and, additionally, floating sitters must beavailable to relieve local sitters for breaks, personal time and lunch.

Here again, the cost to the HCF of sitter service can be astronomical.What is needed is a sitter management system which enables a more costeffective approach to sitter care of patients, while not sacrificing oreven increasing the standard of care to the patients.

BRIEF SUMMARY OF THE INVENTION

The present invention is directed to an electronic sitter managementsystem coupled to patient surveillance network having a plurality ofvideo cameras, each camera transmitting a stream of surveillance videoof a respective patient room system, and method and software product forimplementing. The sitter management system includes at least one sittermanagement device and a plurality of sitter monitoring devices. Eachsitter monitoring device being assigned a plurality of patient rooms andcapable of receiving a plurality of streams of surveillance video forthe corresponding plurality of patient rooms and simultaneouslydisplaying a plurality of video images of the corresponding plurality ofpatient rooms. Each device is also capable of transmitting sitter deviceavailability information to the sitter management device. The sittermanagement device being capable of recognizing a sitter device beingunavailable and reassigning the plurality of patient rooms previouslyassigned to the unavailable device to other of the plurality of sitterdevices that are available.

The sitter management device initially assigns each of the patient roomsurveillance videos to display on specific sitter monitoring devices.Whenever a sitter monitoring device becomes unavailable to displaypatient room surveillance videos, such as when the sitter is interactingwith a single patient, the unmonitored patient room surveillance videosare rolled over to other sitter monitoring devices that are available toreceive video. Several rollover methods for distributing the unmonitoredpatient room surveillance videos can be employed: Blast is where theunmonitored patient room surveillance videos are reassigned to all othersitters that are currently available; Round robin distribution is wherethe unmonitored patient room surveillance videos are reassigned to othersitters based on the next available sitter on a utilization list; Equaldistribution is where the unmonitored patient room surveillance videosare reassigned to other sitters based on equalizing sitter loading;Blueprint is where the unmonitored patient room surveillance videos arereassigned to other sitters within a specific range based on thehospital blueprint; Wi-Fi proximity is where the unmonitored patientroom surveillance videos are reassigned to other sitters within aspecific range based on what wireless access point their device isconnected to; GPS is where the unmonitored patient room surveillancevideos are reassigned to other sitters based on proximity using thedevice's GPS; and No rollover is where the unmonitored patient roomsurveillance videos are not reassigned to other sitters.

From time to time, sitter monitor devices receive alertness tests forchecking the attentiveness of the sitter. If the sitter respondspromptly to the test, the test is merely logged. If the sitter does notrespond, then the electronic sitter management system takes action toprotect the patients being monitored by the sitter. Initially, theelectronic sitter management system may issue and alert to the sitter'smanager and to the sitter, reminding the sitter. Alternatively, theelectronic sitter management system may consider the sitter monitordevice to be unavailable and invoke the rollover policies. In that case,the sitter monitor device is unauthorized and the patients beingmonitored are reassigned to other sitters using one of the rollovermethods.

Additionally, the sitter monitoring device logs all important events orinteractions by the sitter. Typically, the events are merely written toa log that is viewable by the sitter's manager at the sitter managementdevice. However, in certain cases, sitter events, corresponding data andpatient surveillance video may be flagged for recordation in thepatient's medical records. This data may include notes and commentsentered on the sitter monitoring device by the sitter.

An electronic sitter management system coupled to patient surveillancenetwork, the patient surveillance network comprising a plurality ofvideo cameras for transmitting a stream of patient surveillance videofor each of the respective patient rooms, each of the plurality of videocameras located in a patient room and aimed at an interior of therespective patient room. The electronic sitter management systemcomprising a plurality of sitter monitor devices, and each sittermonitor device comprising a video display for displaying at least onestream of patient surveillance video transmitted from one of theplurality of video cameras located in the patient room, a sitterinterface object for receiving a sitter interaction and for generating asitter interaction signal, a device availability information generatorfor receiving the sitter interaction signal and generating one ofavailability information for designating the sitter monitor device asbeing available to receive the at least one stream of patientsurveillance video and unavailability information for designating thesitter monitor device as being unavailable to receive the at least onestream of patient surveillance video and a network connection forreceiving the at least one stream of patient surveillance videotransmitted from one of the plurality of video cameras located in thepatient room and for transmitting the one of availability informationand unavailability information.

The electronic sitter management system also comprising a sittermanagement device comprising a patient assignment component forassigning a first stream of patient surveillance video for a firstpatient room for display on a first sitter monitor device of theplurality of sitter monitor devices, and for assigning a second streamof patient surveillance video for a second patient room for display on asecond sitter monitor device of the plurality of sitter monitor devices,and for assigning a third stream of patient surveillance video for athird patient room for display on a third sitter monitor device of theplurality of sitter monitor devices, and a rollover patient assignmentcomponent for receiving first unavailability information for designatingthe first sitter monitor device as being unavailable to receive thefirst stream of patient surveillance video for the first patient roomfor display on the first sitter monitor device and for rolloverassigning the first stream of patient surveillance video from the firstsitter monitor device.

The rollover patient assignment component of the electronic sittermanagement system for rollover assigning the first stream of patientsurveillance video from the first sitter monitor device to the secondsitter monitor device, wherein the second video display of the secondsitter monitor device simultaneously displays the second stream ofpatient surveillance video for the second patient room and the firststream of patient surveillance video for the first patient room.

The rollover patient assignment component of the electronic sittermanagement system for assigning the first stream of patient surveillancevideo from the second sitter monitor device to the first sitter monitordevice, wherein the second video display of the second sitter monitordevice displays the second stream of patient surveillance video for thesecond patient room and the first video display of the first sittermonitor device displays the first stream of patient surveillance videofor the first patient room.

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS

The novel features believed characteristic of the present invention areset forth in the appended claims. The invention itself, however, as wellas a preferred mode of use, further objectives and advantages thereof,will be best understood by reference to the following detaileddescription of an illustrative embodiment when read in conjunction withthe accompanying drawings wherein:

FIG. 1 illustrates a view from a monitoring device positioned at a nursestation as is known in the prior art;

FIG. 2 is a diagram of the logical structure of an advanced patientsurveillance system;

FIG. 3 is a diagram of the logical structure of an advanced patientsurveillance system with an electronic patient sitter management systemimplemented thereon;

FIG. 4 is a diagram of an exemplary patient monitoring system showingimprovements for implementing the present electronic patient sittermanagement system in accordance with one exemplary embodiment of thepresent invention;

FIG. 5 is a topological view of a healthcare facility including patientrooms, multiple HCF stations, an ICU and corridors with a sittermanagement system implemented therein in accordance with variousexemplary embodiments of the present invention;

FIGS. 6A and 6B graphically represent the redistribution of patientsfrom one sitter group to another sitter group based on a sitter becomingunavailable in accordance with various exemplary embodiments of thepresent invention;

FIGS. 7A and 7B are a flowchart depicting the high level method forimplementing the electronic patient sitter management service inaccordance with an exemplary embodiment of the present invention;

FIGS. 8A and 8B depict a flowchart for a method for setting sitterdistributions and sitter assignments within the electronic patientsitter management system in accordance with one exemplary embodiment ofthe present invention;

FIGS. 9A and 9B illustrate a flowchart for a process directed toestablishing a sitter rollover assignment policy and invoking thoserollover policies in accordance with an exemplary embodiment of thepresent invention;

FIGS. 10A and 10B depict a flowchart of method performed by theelectronic patient sitter management system for logging events andissuing alerts and rollover policy in accordance with exemplaryembodiments of the present invention;

FIG. 11 is a diagram of a sitter manager patient assignment screen aspresented on a sitter manager device in accordance with an exemplaryembodiment of the present invention;

FIG. 12 is a diagram of a sitter manager patient assignment screenshowing patient assignments to specifically identified sitters inaccordance with an exemplary embodiment of the present invention;

FIG. 13 is a diagram of a sitter manager patient assignment screenshowing the assignments of other patients to other specificallyidentified sitters in accordance with an exemplary embodiment of thepresent invention;

FIG. 14 is a diagram of a sitter manager monitor mode screen formonitoring a specific sitter and showing event log data otherinformation associated with that sitter in accordance with an exemplaryembodiment of the present invention;

FIGS. 15-18 are diagrams of various sitter log in and registrationscreens presented on a sitter device and useful for registering andlogging on a sitter to the presently described electronic patient sittermanagement system in accordance with an exemplary embodiment of thepresent invention;

FIG. 19 is a diagram of a sitter main monitoring screen presented on asitter device in landscape presentation mode and useful for presenting asitter with real-time surveillance video of the sitter's assignedpatients and sitter/patient tools associated with the patients inaccordance with an exemplary embodiment of the present invention;

FIG. 20 is a diagram of a sitter main monitoring screen presented on asitter device in portrait presentation mode and useful for presenting asitter with real-time surveillance video of the sitter's assignedpatients and sitter/patient tools associated with the patients inaccordance with an exemplary embodiment of the present invention;

FIG. 21 is a diagram of a sitter main monitoring screen presented inFIG. 20, but on a sitter device in landscape presentation mode, alsopresenting real-time surveillance video of the sitter's assignedpatients and sitter/patient tools associated with the patients inaccordance with an exemplary embodiment of the present invention;

FIG. 22 is a diagram of an enhanced sitter patient monitoring screenpresented on a sitter device in portrait presentation mode for isolatingsurveillance video taken from patient room 302 and also showing varioussitter/patient tools associated with that patient in accordance with anexemplary embodiment of the present invention;

FIG. 23 is a diagram of an enhanced sitter patient monitoring screenpresented in FIG. 22, but presented on a sitter device in landscapepresentation mode for isolating surveillance video taken from patientroom 302, showing various sitter/patient tools associated with thatpatient, but also showing real-time patient vital signs medical data inaccordance with an exemplary embodiment of the present invention;

FIG. 24 is a diagram of an enhanced sitter patient monitoring screenpresented in FIGS. 22 and 23, presented on a sitter device in landscapepresentation mode for zooming in on the patient bed from surveillancevideo taken from patient room 302 and also showing varioussitter/patient tools and vital signs medical data associated with thatpatient in accordance with an exemplary embodiment of the presentinvention;

FIG. 25 is a diagram of an enhanced sitter patient monitoring screen forzooming in on the patient bed from surveillance video taken from patientroom 302 and also presented in FIG. 24, the enhanced sitter patientmonitoring screen is presented on a sitter device in landscapepresentation mode, showing various sitter/patient tools and vital signsmedical data associated with that patient, but also depicting a pair ofvirtual bed rails objects graphically overlaid on the patient bed inaccordance with an exemplary embodiment of the present invention;

FIG. 26 is a diagram of a sitter main monitoring screen presented on asitter device in landscape presentation mode useful for monitoringreal-time surveillance video of patients assigned to a sitter, showingvarious sitter/patient tools and depicting a pair of virtual bed railsobjects graphically overlaid on one patient bed in accordance with anexemplary embodiment of the present invention;

FIG. 27 is a diagram of a sitter patient attend monitoring screen forshowing real-time surveillance video of a patient under individual careof the sitter, the screen is presented on a sitter device in landscapepresentation mode, showing vital signs medical data associated with thatpatient and also depicting a pair of virtual bed rails objectsgraphically overlaid on the patient bed in accordance with an exemplaryembodiment of the present invention;

FIG. 28 is a diagram of a sitter patient attend screen showing a LEAVEscreen object for acknowledging that the sitter intends to leaveindividual patent attend mode and begin monitoring his other assignedpatients in accordance with an exemplary embodiment of the presentinvention;

FIG. 29 is a diagram of a sitter main monitoring screen on a sitterdevice in landscape presentation mode, also presenting real-timesurveillance video of the sitter's assigned patients and one temporaryrollover assigned patient and sitter/patient tools associated with thepatients and temporary rollover assigned patient in accordance with anexemplary embodiment of the present invention;

FIG. 30 is a diagram of a sitter main monitoring screen on a sitterdevice in landscape presentation mode, also presenting real-timesurveillance video of the sitter's assigned patients and sitter/patienttools associated with the patients and further showing one patient roomtriggering a motion sensor alarm in accordance with an exemplaryembodiment of the present invention;

FIG. 31 is a diagram of a sitter main monitoring screen on a sitterdevice in landscape presentation mode, also presenting real-timesurveillance video of the sitter's assigned patients and sitter/patienttools associated with the patients and further showing one patienttriggering a virtual bed rail fall detection alarm in accordance with anexemplary embodiment of the present invention; and

FIG. 32 is a diagram of a sitter main monitoring screen on a sitterdevice in landscape presentation mode, also presenting real-timesurveillance video of the sitter's assigned patients and sitter/patienttools associated with the patients and further showing a sitteralertness test and sitter response objects useful for randomly testing asitters alertness during sitting shifts in accordance with an exemplaryembodiment of the present invention.

Other features of the present invention will be apparent from theaccompanying drawings and from the following detailed description.

DETAILED DESCRIPTION OF THE INVENTION

Element Reference Number Designations 200: Patient surveillance system202: Patient room video surveillance cameras/set top boxes 204: Medicalrecords 206: Entertainment services 208: System administration 210: Datatransmission network 212: HCF professional stations 216: Patientmonitoring 218: Security 220: Internet services 222: Motion sensing 224:Virtual Bed Rails Service 300: Patient surveillance system 302: Touchscreen 304: webcam 352: Patient sitter services 353: Sitter app 354:Sitter manager app 355: Sitter management software 356: Wireless accesspoint 360: Sitter device 361: Sitter (patient monitoring) device 362:Sitter (patient monitoring) device 363: Sitter (patient monitoring)device 36n: Sitter (patient monitoring) device 400: Patient room 402:Patient surveillance sub-system 410: Camera control device 411:Processor unit 412: Network controller 413: Video processor controller414: Primary nonvolatile 415: Secondary nonvolatile memory 417:Television/Monitor 418: Medical procedure remote interface 422: Medicalprocedure interface 424: Patient vital signs monitoring device 426:Pillow speaker interface 450: HCF professional station (nurse station)460: HCF surveillance/monitor device (nurse surveillance/monitor device)470: Patient monitoring sub-system 461: Processor unit 462: Networkcontroller 463: Video processor controller 464: Primary nonvolatile 465:Secondary nonvolatile memory 467: Monitor/Touch screen 468: Audio 469:Manual interface device 500: HCF 506: ICU 508: Corridor 561: Group 1sitter device 562: Group 2 sitter device 563: Group 3 sitter device 564:Group 4 sitter device 600: HCF 661: Sitter device assigned to group 1662: Sitter device assigned to group 2 663: Sitter device assigned togroup 3 664: Sitter device assigned to group 4

In the following description, reference is made to the accompanyingdrawings that form a part hereof, and in which is shown by way ofillustration, specific embodiments in which the invention may bepracticed. These embodiments are described in sufficient detail toenable those skilled in the art to practice the invention, and it is tobe understood that other embodiments may be utilized. It is also to beunderstood that structural, procedural and system changes may be madewithout departing from the spirit and scope of the present invention.The following description is, therefore, not to be taken in a limitingsense. For clarity of exposition, like features shown in theaccompanying drawings are indicated with like reference numerals andsimilar features as shown in alternate embodiments in the drawings areindicated with similar reference numerals.

In view of the shortcomings in sitter services described above, anelectronic patient sitter management system and method for implementingis presented below in accordance with various exemplary embodiments ofthe present invention. An exemplary sitter management system comprisespatient surveillance system (for example, of the type discussed above inU.S. Pat. No. 7,477,285 and U.S. application Ser. Nos. 12/589,654,12/804,774 and 61/513,523), a plurality of sitters (these personnelgenerally have relatively little medical training), each sitter isassigned a mobile computer, tablet, or smart phone (device) that iscapable of receiving real time patient surveillance video generated bythe patient surveillance system, for patients' rooms assigned to therespective sitter, and a sitter management device. Optimally, thepresently described sitter management system is designed to manage thesitter-patient workload such that the need for intervention by higherskilled HCF professionals is minimized. In so doing, the HCFprofessionals are free to devote their medical talents to moreappropriate tasks, commiserate with their respective skill sets.

One aim of the presently described electronic patient sitter managementsystem and method is to efficiently distribute the sitter workload fromthe inefficient and expensive local sitter paradigm to more dynamic andefficient electronically managed sitter monitoring system. In accordancewith one exemplary embodiment of the present invention, the electronicpatient sitter management system ensures that all patients in need ofsitter services are continually monitored by a sitter. In accordancewith another exemplary embodiment of the present invention, theelectronic patient sitter management system enables one sitter tosimultaneously and continuously monitor multiple patients. In accordancewith still another exemplary embodiment of the present invention,patients that are assigned to sitters that become unavailable formonitoring are temporarily and automatically rolled over to othersitters that are available for sitter monitoring duties. In accordancewith still another exemplary embodiment of the present invention, theelectronic patient sitter management system allows sitter managers,either manually, autonomously or both, to test and verify the sitter'salertness, verify and track sitter locations, communicate with andvisually monitor the sitters. In accordance with still another exemplaryembodiment of the present invention, the electronic patient sittermanagement system automatically logs patient and/or sitter events thatmay be important in evaluating a sitter's performance or for thepatient's medical records.

The presently described electronic patient sitter management system maybe more completely understood by comparing the logical structure of thesitter management system with the logical structure of a patientsurveillance system as previously discussed. FIG. 2 is a diagram of thelogical structure of an advanced patient surveillance system and FIG. 3is a diagram of the logical structure of an advanced patientsurveillance system with an electronic patient sitter management systemimplemented thereon. The components represented within the figures maybe implemented as physical structures or as nonphysical elements such asapplications, services or the like. Typically, patient surveillancesystem 200 comprises a plurality of patient room video surveillancecameras 202, which may be incorporated in or with set top boxes inpatient rooms (see FIGS. 4 and 5, for example). For simplicity indescribing the invention, patient room video surveillance cameras 202may be referred to alternatively as set top boxes 202, which includevideo cameras and or video capabilities. Each of patient room videosurveillance cameras 202 is connected to data transmission network 210for bidirectional communication with, for example, one or moremonitoring and/or control devices located at HCF professional stations212, system administration 208, security 218 or other patientsurveillance management nodes (not shown). For completeness, theseelements are further depicted with regard to an HCF in FIGS. 4 and 5.Also present are a plurality of HCF services that may be resident ineach of patient room video surveillance cameras (set top boxes 202), orin the monitoring and/or control devices (such as the nurse monitoringdevice discussed above, referred to below as HCF surveillance/monitordevice 460 (nurse surveillance/monitor device 460) of patient monitoringsub-system 470 with regard to FIGS. 4 and 5). These services include,but are not limited to, medical records 204 for receiving and storingpatient medical records, such as patient surveillance video,entertainment services 206 coupled to the patient's set top box forpatient entertainment, system administration 208 for controlling andimplementing administration policies (usually the HCF's network serverslocated at the HCF administration facilities), applications and softwarefor, for example, patient surveillance system 200, HCF professionalstation 212 for receiving and viewing patient surveillance video in realtime and for communicating and controlling service in patient room videosurveillance cameras 202, security 218 for monitoring the security ofpatient surveillance system 200 and the patients, motion sensing service222 for detecting motion within a video stream from patient room videosurveillance cameras 202 and, optimally, for discriminating patientmovements from motion in the video, and finally, virtual bed railsservices (or chair rails) 224 for detecting patients movements andpredicting a potential patient fall from those patient movements.Finally, patient surveillance system 200 includes Internet service 220which enables patients and HCF professionals access to the Internet.

Patient surveillance system 300 shown in FIG. 3, comprises all of theservice/hardware elements discussed above, and integrates an electronicpatient sitter management system in accordance with an exemplaryembodiment of the present invention. Basically, the presently describedelectronic patient sitter management system is a sitter managementservice that interacts with and communicates with a plurality ofremotely located devices used by sitters in the HCF. These sittermanagement devices comprises, for example, sitter's patient monitoringdevices 361, 362, 363 through 36 n (referred to alternatively as “sitterdevices,” “wireless sitter devices” and sitter device(s) 360) and areprimarily used by sitters for displaying a plurality of real timesurveillance videos taken from a plurality of patient's rooms (and otherrelevant information). Each of sitter devices 360 contains a networkconnection for connecting to data transmission network 210, optimallywirelessly linked via one or more wireless access points 356. Thisenables each of sitter devices 360 to receive real time patientsurveillance video and other pertinent real-time patient information,from one or more of patient room video surveillance cameras 202 that areassigned to the particular sitter logged onto the sitter device.

Also comprising the electronic patient sitter management system issitter management service 352, which essentially comprises threesubservices or software applications that interact with one-another andother HCF devices and equipment: sitter application(s) 353 for use by asitter on, for example sitter device 360; sitter manager application 354for use by a sitter manager on, for example, nurse surveillance/monitordevice 460, and sitter management software 355 that is under the controlof a sitter manager and/or system administrators that essential invokessitter policies and manages the separate applications and access to HCFdevices and equipment based on those policies. Sitter managementsoftware 355 is executed on, for example, an HCF network server locatedat system administration facilities 208. Essentially, sitter managementsoftware 355 runs in the background to support sitter app 353 and sittermanager app 354 which are each running on unique devices, usuallymobile, and remotely from sitter management software 355. While sittermanagement software 355 is resident on a physical device of some type,it is relatively unimportant for the practice of the present inventionwhich device or where the device might be physically located. Forinstance, sitter management software 355 will most probably be deployedremotely from the sitters and/or sitter managers on a network serverlocated in system administration 208 (see FIG. 5 for a representation ofsystem administration 208 within HFC 500). However, sitter managementsoftware 355 may also be resident on devices at HCF surveillance/monitordevice 460 of patient monitoring sub-system 470 located at, for example,HCF professional station 450 (nurse station 450 (again with regard toFIGS. 4 and 5). HCF professional station 450 is typically a personalcomputer, but might be any type of special purpose patient surveillanceand control device. More particularly, because the computationalrequirements of sitter management software 355 are relatively meager,sitter management software 355 might also reside on one of sitterdevices 361, 362, 363 through 36 n that is under the control of a sittermanager.

Sitter app 353, on the other hand, is operated by and under the controlof a sitter for monitoring the sitter's assigned patients and typicallyruns on one or all of sitter devices 361, 362, 363 through 36 n; thenumber of authenticated instances of sitter app 353 running at anyparticular time is dependent on the HCF's sitter demands. These sitterdevices, which will be described in greater detail below, are optimallyembodied as a light weight wireless computing device of some type,usually a smart device or tablet. Alternatively, it may be possible,although far less desirable, to install instances of sitter app 353 onstatic devices such as on nurse monitor device 460 (see FIG. 4 below)located at HCF professional stations 212.

Sitter manager app 354 is used by sitter managers to distribute, assign,manage and monitor sitters, and to monitor the sitter's interactionswith their respective patients. Sitter manager app 354 may run onvirtually any device under the control of a sitter manager. If sittermanagement is the responsibility of a nurse or other HCF professional,sitter manager app 354 may run on nurse monitor device 460 at HCFprofessional stations 212. Alternatively, sitter manager app 354 mayalternatively run on sitter device 360 that is under the control of asitter manager. Notably, because instances of sitter app 353 and sittermanager app 354 are secure and require login passwords, the applicationsmay reside, even simultaneously, on virtually any HCF device that canaccess network 210. Conversely, the HCF administrator may require that afresh instance of sitter app 353 and/or sitter manager app 354 bedownloaded from sitter management software 355 at each login. Thisflexibility enables HCF administrators and other HCF professionals toinstall the app, especially sitter manager app 354, on their personalsmart devices for monitoring and/or managing sitter.

Optionally, a sitter should be authenticated on one of sitter devices360 before the electronic patient sitter management system will considerthe sitter for patient assignments. The initial set up and assignmentinvolves the sitter taking possession of one of sitter devices 360, onwhich they are asked to register/log in to the system (see FIGS. 7A, 7B,8A and 8B, below). Once logged in, they are assigned one or morepatients/rooms from a remote management console (sitter managementservice 352). Optionally, patients and room assignments to each sitterare recommended based on specific needs of the patient, the sitter'sexperience or other qualifications and existing conditions.

If sitter device 360 is lost or stolen, the authentication is revokedand the information on the device is automatically either locked, wiped,or “bricked”. Depending on policy and security requirements, one or moreof the following authentication methods may be implemented. TheUsername/Password method is preferred where the sitter is prompted for aunique username and password in order to log in. Once logged in, anypatients attached to their account are available for them to monitor(see FIGS. 7A, 7B, 8A and 8B discussed below along with screenpresentations examples in all of FIGS. 11-18). Any events or actionsthat occur are attached to their account in the audit log (alsodiscussed below in great detail). The Hardware Device ID method wherethe device's unique identifier, such as wireless MAC address or UDID, isused to validate, authenticate, and assign patients. Again, any eventsor actions that occur are attached to the device in the audit log (eventlogging is discussed below). The Assigned Device ID method where thedevice's manually assigned identifier, such as “Device #13”, is used tovalidate, authenticate, and assign patients. Any events or actions thatoccur are attached to the device in the audit log (event logging isdiscussed below).

As will be understood from the following description, the presentlydescribed electronic patient sitter management system enables HCFs theability to monitor multiple patients using a single sitter, whilesimultaneously managing and monitoring the performance of individualsitters, or the entire group of sitters logged on to the sittermanagement service at any one time. The presently described electronicpatient sitter management system offers the flexibility to allow forsingle patient interaction by a sitter without sacrificing patientmonitoring of other patients assigned to that sitter. This flexibilityalso enables sitters' ample opportunities for scheduled and unscheduledrest breaks. Additionally, the present electronic patient sittermanagement system is infinitely reconfigurable for adapting to anyunforeseen and emergency events that might be encountered by the sittersor by the sitter management system. The present electronic patientsitter management system is relatively uncomplicated and as such can bereadily adapted to any HCF having a patient monitoring or surveillancesystem. Alternatively, the present electronic patient sitter managementsystem might be configured as a stand alone sitter-patient monitoringsystem by using wireless (or even wired) surveillance cameras (WIFI,Bluetooth, wireless IP or the like), positioned in patient rooms. Thesefeatures will be more apparent with a discussion of an exemplaryphysical structure for implementing the present electronic patientsitter management system.

FIG. 4 is a diagram of some exemplary components that may be consideredfor implementing the present electronic patient sitter management systemin accordance with one exemplary embodiment of the present invention.Typically, the present electronic patient sitter management system isimplemented in a patient surveillance network (a portion of or all ofHCF data transmission network 210 represented in FIGS. 2 through 6),which usually comprises at least patient surveillance sub-system 402 andpatient monitoring sub-system 470. As may be appreciated, the presentelectronic patient sitter management system may also be implementedacross several physical locations, such as patient rooms 400 (containingpatient surveillance sub-system 402), nurse station 450 (containingpatient monitoring sub-system 470) or on a network server located atsystem administration 208. The separate sub-systems may also be realizedin virtually any location in the HCF, such as the offices for patientadministration, billing, medical records and network administration,depending on the duties of the particular location. FIG. 5, which willbe discussed further below, is a diagram of an exemplary HCF in whichthe present electronic patient sitter management system may beimplemented.

The components that are typically located in patient surveillancesub-system 402, such as in patient room 400, and accessible by theelectronic patient sitter management system, includes camera controldevice 410 (which correlates to set top box 202 discussed above withregard to FIGS. 2 and 3) that is usually juxtaposed to television 417,but is not essential to the practice of the present invention (see FIG.5). In most patient rooms 400, television/video monitor 417 is installedat a central location which is also a highly advantageous viewpointlocation for installing surveillance camera 202. Additionally, anoptional microphone (not shown) may be disposed on surveillance camera202, camera control device 410 or connected as a separate peripheral forcapturing audio in the surveillance area. Hence, for many installations,camera control device 410, television 417 and surveillance camera 202are loosely coupled together as a unit. In any case, camera controldevice 410 provides the local processing, storage and networkconnections for the surveillance peripherals and for the present patientmedical procedure documentation system. Here it should be mentioned thatmuch of the functionality of the present invention may be embodied in astandard personal computer, however, other aspects of the presentinvention may require supplemental video processing and/or storagecapacity. Furthermore, as may be appreciated from the description of theset-top box in copending U.S. patent application Ser. Nos. 10/735,307and 12/151,452, camera control device 410 may also have CATV, Internet,PSTN and other capabilities that are not traditionally found in astandard personal computer.

With further regard to camera control device 410, processor unit 411diagrammatically represents all the processing capacity, RAM and ROMmemory, busses and the physical framework for storing and executinginstructions for operating the other components of the control unit.Network controller 412 provides a connection to wired and/or wirelessHCF distribution network 210 and to other devices connected to the HCFnetwork, such as nurse monitor device 460 of patient monitoringsub-system 470. Video processor 413 comprises any video processingcapabilities necessary for capturing, processing and/or displaying anyvideo and/or patient medical procedure documentation screens. Videoprocessor 413 may be integrated in a general purpose processing systemor supplement the video processing capabilities of the general purposeprocessing system. As such, video processor 413 is responsible forreceiving the captured video frames from video camera 202, analyzingvideo for motion (see copending U.S. patent application Ser. Nos.10/735,307 and 12/151,452), prioritizing video frames based on contentor external factors (such as labeling the frames as documentation for apatient medical procedure) and compiling medical procedure informationscreens for display on the local monitor, such as TV 417 (see FIG. 10).

Camera control device 410 also comprises receiver/interrogator anddevice communication interface 418 for communicating with a medicalprocedure sensing device (which may be embodied as a manual orautonomous remote interface for sensing an event indicative of thecommencement of a patient medical procedure). Optimally,receiver/interrogator and device communication interface 418 providesmultiple communications ports for connecting with various input devices,such as medical procedure interface 422 and/or pillow speaker interface426. One other purpose for device communication interface 418 (or asimilar device embodied within patient surveillance sub-system 402) isto interface with various patient medical sensing and monitoring devices(referred to hereinafter as vital signs monitoring devices 424) forcreating visual display of a patient's vital signs (or other pertinentpatient data) on sitter device 360. Those patient vital signs data thatcan be presented simultaneously with and superimposed on the patient'ssurveillance video for real time patient monitoring of patient vitalsigns by a sitter or the sitter's manager. Hence, medical devicecommunication interface 418 may communicate with multiple types ofpatient medical sensors and vital signs monitoring devices 424, e.g.,patient monitors, blood pressure monitors, sleep monitors, capnographs,fetal monitors, and the like for sensing and monitoring various bodilyfunctions, i.e., heart rate, respiration, blood pressure,electrocardiogram, electroencephalogram and respiration gases to mentiona few. These devices may be specially designed for interfacing withpatient surveillance sub-system 402 and/or medical device communicationinterface 418 of camera control device 410 or might instead be legacydevices adapted with a specialized interface for communicating withmedical device communication interface 418.

Patient medical sensors and vital signs monitoring devices 424 mayoperate autonomously (usually by sensing the presence of an HCprofessional through autonomous sensing devices) or manually byreceiving manually invoked communication from a HCF professional on itsinterface. In either case, the aim is for camera control device 410 toreceive supplemental information indicative of the commencement (andpossibly termination) of a patient medical procedure. The receipt ofthis information enables camera control device 410 to flag anysubsequently captured NV data as documentation for the informationindicative of a patient medical procedure. Hence, that NV data may beprioritized and/or backed up locally for access in the future. To thatend, camera control device 410 comprises at least one nonvolatile memoryfor storing A/V data documentation of a patient medical procedure.

As also depicted in FIG. 4, camera control device 410 further comprisesprimary nonvolatile memory 414 and secondary nonvolatile memory 415, forstoring different classes of captured A/V data. The storing operationsof camera control device 410 contemplate that the surveillance datareceived by camera control device 410 may comprise varying degrees ofimportance. Most surveillance data received by camera control device 410is of relatively low importance. The surveillance data are simplytransmitted to monitoring device 460, in near real time, for temporalmonitoring by an HC professional, such as a nurse at nurse station 450.Since that data has a relatively low priority, it will be the first datato be temporally overwritten by fresher surveillance data received atcamera control device 410. More important surveillance data received bycamera control device 410 may be flagged for further review by an HCprofessional. This type of data might include NV data that failed to beimmediately transmitted over distribution network 210 due to networkbandwidth or operation issues. Various techniques may be applied to thisdata for achieving a rapid resolution to the problem, such as alarms,frame rate reduction and locally backing up the NV data. However, forthe purposes of the presently described electronic patient sittermanagement system, it is assumed that the sitter should and will receivepatient surveillance video in real-time, albeit at somewhat lower framerates depending on the amount of data traffic on HCF data network 210.

The operation and protocols of primary nonvolatile memory 414 andsecondary nonvolatile memory 415 are an important part of the presentpatient surveillance system, however, their precise functionality arerelatively unimportant for the purposes of describing the presentelectronic patient sitter management system, and therefore will not bediscussed in further detail (see copending U.S. patent application Ser.Nos. 10/735,307 and 12/151,452 for a discussion of primary nonvolatilememory 414 and secondary nonvolatile memory 415).

The present electronic patient sitter management system makes use of thepatient surveillance system for sitter operations without the need formodifying the surveillance network or altering the manner in which thepatient surveillance system operates. Hence, the HCF need not invest inextravagant modifications to the base patient surveillance network fordeploying the sitter management service.

Operationally, the presently described electronic patient sittermanagement system promotes the efficient use of sitter resources byauthorizing and de-authorizing sitters to the system, managing patientdistributions to authorized sitters, automatically implementing rolloverpolicies (described below) when necessary, coupling sitter communicationdirectly to charge HCF professionals for their respective patients (notnecessarily to a single HCF station) and continually testing andverifying the alertness of the authorized sitters. However, it shouldnot be overlooked that the primary function of sitter devices 361, 362,363-36 n is to allow the sitter monitoring locations to be differentfrom the patient's room. Moreover, because sitter devices 361, 362,363-36 n are wireless and thereby mobile, a sitter may be positioned inan optimum location to each patient's room that is assigned to thesitter.

The deployment and distribution of sitters, along with their sitterdevices, is shown on FIG. 5, which is a topological view of HCF 500including patient rooms 400, HCF stations 450A, 4504B and 450C, ICU 506and corridors 508. Superimposed on HCF 500 are data transmission network210, including patient room video surveillance cameras 202 (onlyrepresentative elements are labeled to reduce clutter). Alsosuperimposed on HCF 500 is the presently described exemplary electronicpatient sitter management system in accordance with various exemplaryembodiments of the present invention.

For the purposes of discussion, the exemplary electronic patient sittermanagement system illustrated herein includes four separate sittermanaged groups, designated groups 1, 2, 3 and 4. Group 1 encompasses thepatients within ICU 506 and is monitored by sitter device 561, which ispositioned within ICU 506. A second sitter monitor group, Group 2, ismonitored by sitter device 562, which is positioned in the corridor inthe upper left of HCF 500. Sitter device 562 is responsible formonitoring three patient rooms, each designated with a “2,” surroundingsitter device 562. Likewise, group 3, is monitored by sitter device 563,which is responsible for monitoring the three other patient roomsdesignated with a “3,” and group 4, is monitored by sitter device 564,which is responsible for monitoring the two patient rooms designatedwith a “4.” In this example, each sitter and device (with the exceptionof ICU) is positioned in a HCF corridor. Alternatively, the sitterscould be stationed at the closest of HCF stations 450A, 450B and 450C,in an empty patient room 400 or within the most centrally locatedpatient room of the sitter's monitor group. Importantly, however, thepatient group assignment is not static, but may be altered, and patientredistributed to remaining sitters, in the event that a sitter becomesunavailable. The precise mechanism for rollover policies andredistributing patients between available sitters is the subject of thedisclosure associated with FIGS. 6A and 6B, however a brief descriptionof the high level operation of the present electronic patient sittermanagement system and method may be useful prior to discussing rolloverconditions and policies.

FIGS. 7A and 7B are a flowchart depicting the high level method forimplementing the electronic patient sitter management service inaccordance with an exemplary embodiment of the present invention. Thehigh level operation may be subdivided into setup operations (mode) andpatient monitoring operations (mode). These operations are accomplishedat one of sitter device 360 (by the sitter using sitter app 353) or asitter management device (by a sitter manager/administrator using sittermanager app 354) depending on the type of operation or responsiveoperation being executed. During the performance of these operations,the sitter(s) and sitter manager will be presented with various uniquescreens for interacting with sitter management software 355 of theelectronic patient sitter management system (exemplary screens aredepicted in FIGS. 12-32). Reference will be made to the screens in thesefigures during the discussion of operations that are relevant to theparticular screen. It is expected that the sitter, at least, will viewsitter device 360 having sitter app 353 executing therein, while thesitter manager that is responsible for the sitter utilizes a separatedevice (perhaps anther sitter device), but with sitter manager app 354executing therein. Both sitter app 353 and sitter manager app 354operate under the direction of sitter management software 355 of sittermanagement service 352, regardless of where, or which device, sittermanagement software 355 executes. As mentioned above, it may be moreoptimal to integrate sitter manager app 354 into sitter managementsoftware 355 for execution on a single device under the control of thesitter manager.

Optimally, sitter device 360 will be a mobile computing device that iswirelessly linked to HCF data network 210 through a secure wirelessaccess point 356 and comprises touch screen 302, webcam 304 and variousbuttons and user controls for controlling power, speakers, accessinghome screen and the like controls that are usually not convenient foruse on a touch screen. While the computation requirements for sitterdevice 360 are only moderate, the device should be able to receive anddisplay multiple video portals of real-time video (usually patientsurveillance video) without lag. Exemplary mobile computing devicesinclude the iPad® available from Apple, Inc. of Cupertino, Calif., theExoPC Slate available from ExoPC of Montréal, Québec and also the HPSlate available from the Hewlett-Packard Company of Palo Alto, Calif.Importantly, sitter device 360 selected for use should be highlyflexible and scalable display capabilities in order to reconfigureinformation displayed (especially video) on touch screen 302 undervarious conditions, e.g., portrait or landscape, and in various levelsof scaling depending on how many patient rooms are to be displayed,e.g., one, two, three or more patient rooms) while retaining theresolution necessary to make important sitter determinations.Importantly, sitter device 360 might also be embodied in any number ofdevices, such as a mobile computer, net device, or smart phone (device)without loss of any functionality to the presently described electronicpatient sitter management system and method.

The sitter management software 355 component of the electronic sittermanagement service 352 may reside on an HCF network server located at,for example, system administration 208. Alternatively, sitter managementsoftware 355 may reside on devices at HCF surveillance/monitor device460 of patient monitoring sub-system 470 located at, for example, HCFprofessional station 450 (nurse station 450 (again with regard to FIGS.4 and 5). HCF professional station 450 is typically a personal computer,but might be any type of special purpose patient surveillance andcontrol device. More particularly, because the computationalrequirements of sitter management software 355 are relatively meager,sitter management software 355 might also reside on sitter device 360that is under the control of a sitter manager as discussed immediatelyabove. As a practical matter, sitter management software 355 is usuallyinstalled on a remote device from sitter manager app 354, consequently asitter manager will rarely interact with sitter management service 352directly from the device that the service is installed, but from adevice supporting sitter manager app 354. More often the sitter manager,similar to the sitter, will interact with sitter management software 355from a remote location, such as on HCF surveillance/monitor device 460,or on sitter devices 360, that is under the physical control of themanager. Optimally, individual sitter devices 360 and other machines,interact with sitter management software 355 though remote applications,applets, routines or software programs that is resident on theparticular devices (i.e., sitter app 353 and sitter manager app 354).

Returning to FIG. 7A, the figure is arranged with sitter tasks in theleft column and the sitter manager's interactions (or those automatedwithin sitter management software 355) in the right column. Relatedtasks/iterations are blocked together for simplifying the discussion ofthe high level processes. In setup mode, a sitter manager uses sittermanager app 354 to call up sitter management software 355 at one of aremote network server located in system administration 208 from localdevice such as HCF surveillance/monitor device 460 or even one of sitterdevices 360 operated by a sitter manager (see 700). The sitter managerassesses the patient requirements for the HCF, or at least for thepatients or areas that the manager is responsible. The sitter manageralso considers the available sitters, including the number of sittersand locations of patient rooms needing sitter services, along with anyspecial sitter requirements of the patients or desires for a sitter of aparticular gender and perhaps the patient's identity or other factorsrelevant for the sitter. While many of these tasks may be accomplishedautomatically by sitter management software 355, it is expected thatpatient/sitter deployment/distribution/assignments and special sitterassignments will generally be under the privy of a sitter manager and,therefore, can be altered or updated manually by the sitter manager.

A sitter manager launches electronic patient sitter management service352 from sitter management software 355 and in response, availablesitters are presented with a login/registration selection screen ontheir respective sitter devices 360 as depicted in FIG. 15 (see 702).Ideally, the login/registration selection screen is user interactivescreen with LOGIN button 1502, for registered sitters to login toelectronic patient sitter management service 352 and REGISTER button1504, for unregistered sitters to register with electronic patientsitter management service 352. Optionally, the login/registrationselection screen may also contain sitter MANAGER CHAT button 1506 forestablishing a chat with the sitter's manager and REQUEST ASSISTANCEbutton 1508 for requesting assistance with the login. FIG. 16illustrates a basic sitter login screen with USERNAME entry field 1602,PASSWORD entry field 1604 and LOGIN button 1606. In addition, thelogin/registration selection screen may also contain MANAGER CHAT button1608 and REQUEST ASSISTANCE button 1610, as in FIG. 16. FIG. 17illustrates a sitter registration screen with USERNAME entry field 1702,PASSWORD entry field 1704 and PASSWORD reentry entry field 1706 for thesitter to selected and enter a unique username and password, and alsoNAME entry field 1708 for the sitter to enter a name that can becorrelated to a sitter account resident at sitter management software355. As an additional security feature, it is expected that sittermanagement software 355 will not authenticate any sitter registrationunless a sitter account has been set up in advance at sitter managementsoftware 355 by a sitter manager or administrator. Finally, sitter loginscreen displays REGISTER button 1710 for the sitter to transmit thesitter's registration information to sitter management software 355 ofsitter management service 352. Based on the sitter's entry data (usuallyby comparison with the names of sitters that may be authorized access tothe system) sitter management software 355 either registers the sitterwith the system, or rejects the sitter. Here again, in order to expediteand login complications, the login/registration selection screen mayalso contain sitter MANAGER CHAT button 1712 for establishing a chatwith the sitter's manager and REQUEST ASSISTANCE button 1714 forrequesting additional assistance with the login. Because a typicalsitter is usually not a proficiently trained HCF professional such as anurse, many sitter screens provide the sitter with an option to invoke amanager chat with the sitter's manager, or more often, provides thesitter with a REQUEST ASSISTANCE button, for summoning help from anappropriate source for the particular screen that the sitter is viewing.Typically, in the patient monitor mode, issuing a REQUEST ASSISTANCEcommand will solicit a response from an HCF professional in charge ofthe particular patient room being monitored, or from the sitter'smanager.

Upon authorization of the sitter by sitter management software 355,sitter app 353 receives a sitter login verification screen whichdisplays a sitter name and login, as depicted in FIG. 18, and oncepatients are assigned to the sitter displays the assigned patient names(not shown). The purpose of the sitter login verification screen is toacknowledge the sitter's login with login identification box 1802 and toprovide the sitter with temporal news and relevant information. Thesitter login verification screen may also display pertinent information,news, policy and procedure changes and any special considerations orwarning that might be useful to a sitter during his work shift.

With regard to the sitter manager, as sitters are granted access tositter management service 352, the authorized sitter's names aredisplayed as, for example, labels on, or proximate to interactivebuttons in sitter block 1100 on the manager's administrative view andsitter tool screen (see FIG. 11), shown in sitter block 1100 as SITTER1button 1102 and SITTER2 button 1104. Here, the sitter manager assignsthe sitters to patients depending on patient and HCF criteria, such asthe patient's needs (medical and personal care), the location of thepatients' room within the HCF (see the patient assignment block 710) andperhaps based on the patient's gender or the patient's preference for asitter of a particular gender. By selecting one of SITTER1 button 1102or SITTER2 button 1104, the sitter manager can view information relevantto the selected sitter, along with sitter management tools as can beappreciated from the exemplary manager's administrative view and sittertool screen illustrated in FIG. 12. Here, the interface showsauthorization tool block 1210 and sitter room assignment tool block1220, in addition to sitter block 1100. Within the authorization toolblock 1210 is LOG OUT SITTER button 1212 for forcibly de-authorizing asitter from sitter management service 352. In sitter room assignmenttool block 1220 is displayed a plurality of patient rooms. It should beappreciated that in a large or even moderately sized HCF, several HCFprofessionals may be designated as sitter managers. Typically, thesemanagers will be assigned areas of the HCF (e.g., floors, corridors orwings) that are proximate to the HCF professionals' duty station. Once asitter manager logs in, sitter management service 352 will populate themanager's assignments screen with patient rooms under her supervisionand needing sitter services. In sitter room assignment tool block 1220,these patient rooms are presented as ROOM # buttons 1222 through 1234,each identifying a unique room number and having an assignmentverification in the form of small block that is textured with acharacter or color in response to a sitter assignment being made for theroom. The sitter manager uses this screen to assign sitters to patientrooms.

Notice from the exemplary manager's administrative view and sitter toolscreen that the sitter manager has selected SITTER1 button 1102 because,in response to the manager's gesture, the texture of the button hasechoed a change in texture. Notice also that the texture of a ROOM #button correlates to that of the sitter assigned to that specific room,for example ROOM 301 button 1232 and ROOM 302 button 1234 have theidentical texture as SITTER1 button 1102. In addition, a check characterhas been placed in the assignment verification box for patient rooms 301and 302, indicating that the sitter manager has manually assigned sitterone to patient rooms 301 and 302. Conversely, ROOM 300 button 1222, ROOM303 button 1224, ROOM 304 button 1228, ROOM 305 button 1230 and ROOM 306button 1226 are each textured differently from ROOM 301 button 1232 andROOM 302 buttons 1234, indicating that sitter one is not assigned tothose rooms.

Turning now to exemplary manager's administrative view and sitter toolscreen shown in FIG. 13, it can be appreciated that the sitter managerhas already selected SITTER2 button 1104 and in response that button isdisplayed in a highlighted condition on the screen with the activetexture. By contrast, unselected SITTER1 button 1102 displays aninactive texture on the screen. Here again the sitter manager hasselected two patient rooms for assignment to sitter two as depictedtherein, as may be appreciated from the textures of ROOM 303 button 1224and ROOM 304 button 1228 correlating to that the texture of SITTER2button 1104. This selection by the sitter manager is further apparentfrom the assignment verification boxes on those buttons being filledwith check characters that visually acknowledge the selections. In thisassignment state, ROOM 301 button 1232 and ROOM 302 buttons 1234 have analtogether different texture from the active or inactive texturesdisplayed on the other room button. This texture represents that thesitter manager has previously assigned those rooms to a sitter (in thiscase sitter one as discussed with reference to FIG. 12).

ROOM 300 button 1222, ROOM 305 button 1230 and ROOM 306 button 1226remain textured as being inactivate and not assigned.

Once at least one patient room has been assigned to a sitter, sittermanagement service 352 proceeds into the sitter monitoring mode forthose assignments (see 730). Patient monitoring mode tasks/iterationsare blocked together and depicted in FIG. 7B. Here, the sitter monitorshis assigned patients on sitter devices 360 (see 752) and the sittermanager who is responsible for the sitters, supervises the sittermonitoring operations of the sitters (see 750). The primary function ofsitter app 353 on sitter devices 360 is to display information relatingto patient rooms assigned to a particular sitter in a manner that ismost useful for the sitter for real-time monitoring of the condition ofpatients residing within the assigned patient rooms.

FIGS. 19 and 20 illustrate two exemplary post assignment sitter mainpatient monitoring screens. FIG. 19 depicts real-time surveillance videoof patient rooms 301 and 302 in room surveillance frames 1901 and 1902respectively, along with patient management tools corresponding to eachassigned patient room for use by the sitter, in a landscape presentationform. Optimally, room surveillance frames 1901 and 1902 are active andinteractive screen objects that convey some type of information to thesitter via color, texture or animation, or changes in the color ortexture, while simultaneously being receptive for receiving sitterinteractions or gestures from the sitter interacting through touchscreen 302. Some exemplary patient management tools include ATTENDPATIENT buttons 1931 and 1932 for alerting sitter management software355 and the sitter manager via sitter manager app 354 that a patient isin need of individual attention. In making an ATTEND PATIENT selection,the sitter is alerting the system that, temporarily, he will not be ableto monitor his other assigned patient. Consequently, in response to thesitter selection of one of ATTEND PATIENT buttons 1931 and 1932, sittermanagement software 355 automatically invokes sitter rollover policiesfor redistributing the patient assignments from the current sitter, tositters who are not attending individual patients themselves. Rollover,and the policies associated with sitter assignment rollovers andassignment rollover conditions, as well as recovering from rollover willbe discussed below at 756 and 760 and in greater detail with regard tothe flowchart depicted in FIGS. 9A and 9B. Although not shown in thisillustration, the sitter main screen may display other information andpatient management tools, for instance, patient vital sign readings,either as temporal digital data, analog graphic presentation over apredetermines time period, or both.

FIG. 20 depicts an alternative presentation real-time surveillance videoin portrait of patient rooms 300, 301 and 302 in room surveillanceframes 2000, 2001 and 2002, respectively, along with patient managementtools for each assigned patient room. Optimally, surveillance frames2000, 2001 and 2002 are also interactive and active screen objects orframes that convey some type of information to the viewer, e.g.,correspondence to a particular sitter, and alarm, such as patient motionbeing detected by the surveillance system, virtual bedrails, etc. Inaccordance with this example, the sitter main patient monitoring screenis present in portrait presentation form with room surveillance frames2000, 2001 and 2002 arranged accordingly therein. Corresponding to eachroom surveillance frame is ATTEND PATIENT buttons 2030, 2031 and 2032,similar to that depicted in FIG. 19, but also displays NURSE CALLbuttons 2020, 2021 and 2022. Typically, an attending nurse is calledfrom a “nurse call button” located in a patient's room, usually locatedon a pillow speaker, but a supplemental call button may be optionallyprovided on the SitterView sitter main patient monitoring screen.Additionally, the SitterView sitter main patient monitoring screen maydisplay other patient information not shown in these figures, such aspatient names, patient vital signs or other medical information, specialpatient care instructions, etc. Within each screen presentation mode,whether landscape presentation form, portrait presentation form or someother presentation form, the patient room surveillance framesautomatically arrange themselves in the optimal arrangement and size forviewing the individual patient rooms.

By contrast, FIG. 21 depicts an exemplary post assignment sitter mainpatient monitoring screen for the sitter managing the patient roomsdepicted in FIG. 19, with the surveillance video of patient rooms 301and 302 in room surveillance frames 2101 and 2102 respectively, withpatient management buttons 2131 and 2132. Notice however, that patientroom 303 is presented in room surveillance frame 2103. From surveillanceframe legend 2143, it is apparent that room 303 has been temporarilyrollover assigned to this sitter. This patient room was not initiallyassigned to this sitter, but only temporarily rollover assigned to thesitter in response to that patient's original sitter becomingunavailable to monitor the room 303. Patient assignment rollover will bediscussed again with regard to FIGS. 9A and 9B, below.

In a typical sitter's duty shift at a HCF, a sitter will spend themajority of his time monitoring the patients in the patient roomsassigned to him. The only exceptions are usually when the sitter isattending an individual patient, the sitter is on a break or if thesitter becomes distracted. In a typical sitter manager shift at a HCF, asitter manager will spend some time, but not all, managing the sittersunder her charge. One goal of the presently described electronic patientsitter management system is to reduce the workload on the sitter managersufficiently that the responsibility of sitter management might berelegated to existing HCF professionals, such as a charge nurse or thelike. Therefore, the sitter manager's primary responsibility is tomonitor sitters, but to more frequently monitor sitters under certainunusual conditions, such as during an assignment rollover. The remainderof FIG. 7B will be briefly discussed regarding each of those sitterconditions and with regard to an exemplary sitter main patientmonitoring screen correlating to a condition.

Supervising sitters under the control of a sitter manager is, in someregards, similar to a sitter monitoring patient rooms assigned to thesitter. Recall that sitter devices 360 may take the form of a mobilecomputer, tablet, or smart device and as such may be configured withvideo conferencing capabilities such as a backward facing camera (pointstoward the user) and a microphone. These capabilities enable the sittermanager to monitor the sitters under her control in the same manner asthe sitter utilizes patient room surveillance cameras 202 to monitorpatients. FIG. 14 illustrates an exemplary sitter manager administrativeview and sitter tool screen similar to those shown in FIGS. 11-13.However, sitter manager administrative view and sitter tool screendepicted in FIG. 14 provides the sitter manager with a morecomprehensive view of the information relating to sitters under hercontrol.

Essentially, exemplary sitter manager administrative view and sittertool screen is divided into five separate sections, sitteridentification block 1100, device assignment tools block 1410, sitterroom assignment block 1420, sitter activity log 1430, sitter informationblock 1440 and finally, surveillance block 1450. Sitter identificationblock 1100 is populated with screen objects associated with all sittersunder the control of the manager. In this example, the screen object aredepicted as sitter buttons 1102, 1104 and 1106 and the sitter's names,Smith, Johnson and Avery appear as button labels corresponding to aparticular sitter. Selecting any of sitter buttons 1102, 1104 and 1106will result in information relevant to that sitter populating sitteractivity log 1430, sitter information block 1440 and surveillance block1450; the device tool in device assignment tools block 1410 will alsocorrelate to the selected sitter's sitter devices 360. In the presentillustrative example, sitter button 1106 that is associated to sitterJack Avery has been selected and sitter information for Jack Avery ispresent in sitter information block 1440. This information might includethe sitter's full name, username, designated location in the HCF andother information relevant to the sitter and sitter's duties.Alternatively. sitter information block 1440 may also includeinformation identifying any special training or skills possessed by thesitter, such as advanced first aid, CPR, etc., as well as any specialHCF equipment assigned to the sitter, such as defibrillators, vitalsigns monitors, resuscitators, aspirators or the like. With theselection of sitter button 1106, surveillance view of Jack Avery appearsin sitter surveillance frame 1452, along with the sitter's name andrelevant timestamp information. Below sitter surveillance frame 1452 aresurveillance tools for monitoring the sitter, these may include videoand audio presentation screen objects. In addition, an activity log ofthe sitter's recently documented events is present in sitter activitylog 1430. Optimally, the log is a rolling display of events that can betraversed by the sitter manager for viewing sitter events recorded bysitter management service 352. Sitter activity log 1430 provides thesitter manager with valuable information concerning the sitter'sattention to events. Documenting sitter events will be discussed ingreater detail below with regard to the flowchart depicted in FIGS. 10Aand 10B. In addition to display information relevant to only theselected sitter, sitter room assignment block 1420 lists all of thepatient rooms having sitters. Optimally, patient rooms screen objectsmay have assignment verification boxes or some other feature fordesignated rooms that are assigned to a selected sitter. Finally, itshould be mentioned that at any time, a sitter manager may access andview any one or all of the post assignment sitter monitoring screens forsitters assigned to her. In so doing, the sitter manager can get areal-time view of the sitter's patients, not just a record of previouslyoccurring events.

Returning to FIG. 7B, the sitter monitor mode continues with the sitteraccessing patient surveillance views on various sitter screens formonitoring patient under the sitter's charge (see 752 on FIG. 7B),exemplary sitter screens are depicted in FIGS. 19-32. In large part, thesitter's duties consist of monitoring a patient for any indication thatthe patient is in need of individual attention, and then provide thatattention to that patient. Two particularly useful sitter screens formonitoring a patient are the enhanced sitter patient management screendepicted in FIGS. 22 and 23 and the enhanced sitter patient managementscreen depicted with patient zoom in as depicted in FIGS. 24 and 25. Asitter navigates to one of the enhanced sitter patient managementscreens from a post assignment sitter main patient monitoring screen byselecting a patient room for selective scrutiny, such as by clicking onsurveillance frame 2102, or its interior video image, for patient room302 on post assignment sitter main patient monitoring screensillustrated in FIG. 21. In response, an enhanced surveillance videoframe for room 302 is presented with patient management tools as can beappreciated from the depictions in FIGS. 22-25.

Firstly, notice each of these exemplary screens presents a sitter withsome sitter tools for interacting with sitter management service 352 andultimately the sitter manager. These tools may include TAKE BREAK button2161, 2261, 2361, 2461 and 2561 presented in the upper header portion ofthe post assignment sitter main patient monitoring screens depicted inFIGS. 22-25. This tool enables a sitter to request a break from thesitter manager. In response, the sitter manager may manually grant thesitter a temporary break from his patient monitoring duties andtemporarily rollover assign the sitter's patients to other sitters whilethe sitter remains unavailable (on break). It is expected that the useTAKE BREAK button xx61 will require the sitter to wait for a responsefrom sitter management service 352 before exiting his patient roommonitoring assignments. However, in case of an emergency, or in a casewhere the sitter intends to logoff of sitter management software 355,that sitter uses LOGOUT button 1962, 2062, 2162, 2262, 2362, 2462, 2562,2662, 2962, 3062, 3162 and 3262 as depicted in the screens presented inFIGS. 19-26 and 29-23. Typically, sitter management service 352automatically rollover assigns the sitter's patient rooms to otheravailable sitters in response to receiving a sitter logout withoutintervention from a sitter manager.

Other exemplary sitter tools for interacting with sitter managementservice 352 might be a RELOAD button 2063 for reloading data andreal-time surveillance video frames (such as in the case of a videofreeze or the like). Also, enhanced sitter patient management screenspresent the sitter with patient management screen objects, includingATTEND PATIENT buttons 2230 and 2330, for notifying sitter managementservice 352 (and the sitter manager) that the sitter will beindividually attending the patient in the enhanced display (see 754 onFIG. 7B), and NURSE CALL buttons 2220 and 2320, for calling theattention of the charge nurse to the patient in the enhanced display.Each of these tools is similar to that depicted in FIG. 19 above. Inaddition, the enhanced sitter patient management screens also presentthe sitter with certain patient tools designed to aid the sitter in hispatient monitoring duties, these include enabling a motion sensorassociated with the patient room, depicted as ENABLE MOTION SENSORbuttons 2240, 2340, 2440 and 2540 and for viewing the superimposedvirtual bed rail 2352, 2354, 2552 and 2554 on FIGS. 23 and 25,respectively, depicted as VIEW VIRTUAL BED RAILS buttons 2250 and 2350,and ENABLE VIRTUAL BED RAILS buttons 2450 and 2550. Interaction ofENABLE MOTION SENSOR buttons 2240, 2340, 2440 and 2540 invokes motionsensing service 222 for the selected patient room that alerts the sitterto any movement detected with the selected patient's room. Optimally,the motion alert is an audible in combination with a visual alertcorresponding to the patient room throwing the alert, for instance, theflashing of room surveillance frames 2200, 2300, 2400 and 2500, or othervisual cue to identify the correct patient room. With regard to VIEWVIRTUAL BED RAILS buttons 2250, 2350, 2450 and 2550, U.S. patentapplication Ser. No. 12/589,654 entitled System and Method forPredicting Patient Falls and Ser. No. 61/513,523 entitled NoiseCorrecting Patient Fall Risk State System and Method for PredictingPatient Falls, describe a mechanism for detecting patient falls bydefining a set of virtual bed rails around the patient. Typically,virtual bed rails service 224, is set up by a HCF professional and notthe sitter, however viewing virtual bed rails 2352, 2354, 2552 and 2554superimposed on the patient surveillance video confirms to the sitterthat motion sensing service 222 has been activated properly. In somecase, the sitter may be granted authority to initiate virtual bed railsservice 224, as well as position and/or reposition virtual bed railobjects 2352, 2354, 2552 and 2554 on the video frame.

In addition to the above, notice in FIGS. 23-25 that enhanced sitterpatient management screens also present the sitter with real-timepatient vital sign readings in exemplary patient vital signs box 2360,2460 and 2560. Although any patient reading from one of vital signsmonitoring devices 424 may be presented in the enhanced sitter patientmanagement screens for the sitter, as either temporal digital data,analog graphic presentation over a predetermined time period, or both,here only the digital readings for pulse, blood pressure (systolic anddiastolic), respiration rate and temperature are displayed.

In any case, the enhanced sitter patient management screens can befurther optimized for viewing only the patient therein using a zoom infeature on the surveillance video. Typically, this is accomplished usingthe diagonal finger spreading gesture across the selected surveillancevideo within one of room surveillance frames 2200 and 2300 (FIGS. 22 and23, respectively) on touch screen 302 which results in the zoomed insurveillance video displayed in room surveillance frames 2400 and 2500(FIGS. 24 and 25, respectively).

With particular attention to the sitter attending an individual patient(see 752 on FIG. 7B), frequently the sitter will be required to renderindividual and personal attention to a particular patient beingmonitored by that sitter. The sitter may determine that one of theassigned patients needs individual attention from the real-time video,or from an automated alarm associated with the assigned patient's room.As discussed immediately above, the presently described electronicpatient sitter management system places a high premium on automatedfeatures for aiding the sitter and sitter manager. One such feature isthe use of motion sensors, referred to in FIGS. 22-25 as ENABLE MOTIONSENSOR buttons 2240, 2340, 2440 and 2540. Another automated featureusable by a sitter is the virtual bed rails movement detection, referredto in FIGS. 23 and 25 for viewing the superimposed virtual bed rail2352, 2354, 2552 and 2554. Typically, a motion detector is a devicethat, when activated, issues an alert (or alarm) if motion is detectedin the detection area, i.e., a patient's room, for instance. The virtualbed rails are also a type of motion detector, however this detector is aspecialized for discriminating patient movement that anticipates apatient fall from a surveillance video. As described in the US patentapplications identified above, a set of virtual rails are placed on thesurveillance video proximate to an area containing a patient, such as apatient's bed, chair, commode, etc. The placement of these virtual railsis accomplished by HCF professionals, such as a nurse, usually not asitter, but in some situations a sitter may be authorized to set up ormodify the location of the virtual bed (chair) rails without assistancefrom another HCF professional.

Once a motion detection device has been activated, either a sensor orvirtual bed rails, the sitter will receive alarms whenever motion isdetected by the motion sensing device. The motion alarm may be visual,audible or preferably a combination of visual and audible. In accordancewith various exemplary embodiments of the present invention, a motionalarm should offer the sitter information as to which motion sensortriggered the alarm. For example, notice in FIGS. 30 and 31, the sittermain monitoring screen is noticeably different from that depicted inFIG. 26, and sitter main monitoring screen depicted in FIG. 30 isdifferent from that depicted in FIG. 31. Sitter main monitoring screendepicted in FIG. 30 shows sitter management service 352 in a motiondetection state precipitated by a room motion sensor in patient room301, while FIG. 31 shows sitter management service 352 in a patient falldetection state precipitated by virtual bed rails video analysis for apatient in a patient bed in room 301. Essentially, in FIG. 30 roomsurveillance frame 3001 and warning screen bar 3065 are textured with ahigh visibility, usually animated, texture designating that the motiondetector in patient room 301 has been triggered. By contrast, inresponse to detecting a potential patient fall via the virtual bed railsanalysis, room surveillance frame 3101 and warning screen bar 3165 aretextured with an even more attention grabbing texture, high visibilityand usually animated, for designating that the patient room 301 has mademovements that usually proceed a fall. In addition to the visual alerts,sitter management service 352 may also issue a unique audible alarm forthe type of alert.

With further reference to blocks 754/756, responding to a motion alarmusually requires immediate action from the sitter. Typically, the sitteraction takes one of two forms, oral communication between the sitter andpatient (patient chat function between sitter device 360 and HCF patientset top box 202), and/or the sitter rendering immediate individualattention to the patient. Patient chat, or more correctly, sitter topatient chat, is preferred because it does not require the sitter toleave his monitoring station to render individual attention to apatient, hence the sitter does not become unavailable for monitoring hisother assigned patients. Patient chat is invoked by the sitter throughthe use of PATIENT CHAT buttons 2270, 2370, 2470, 2570 and 2671 and 2672depicted in FIGS. 22-26. Each patient chat screen object is associatedwith an individual patient room for communication with that room. If thepatient responds appropriately to the sitter chat inquiry, the patientmay not require the individual attention of the sitter. Often, however,patient chat is ineffective because the patient may not be able tocommunicate to the sitter (the patient may be sleeping, recovering froman anesthetic or may be otherwise incapacitated) and the patient maystill require individual attention from the assigned sitter.

As discussed above, once the sitter chooses to provide individualattention to a patient (i.e., leaves his monitoring station), the sitteris effectively unavailable for monitoring any other patients that areunder his care. This condition is unacceptable for the HCF, therefore,the sitter's other patient assignments must be rolled over to othersitters that are available for patient monitoring. A sitter's ability toattend an individual patient cannot wait for an acknowledgement from asitter manager, hence, rolling over patient assignments is essentiallyan automatic function of sitter management service 352, as will bediscussed with regard to FIGS. 9, 10A and 10B below. Initially, thesitter will be monitoring his patients in his assigned patient rooms,such as viewing patient rooms 301 and 302 in surveillance frames 2601and 2602 on post assignment sitter main patient monitoring screendepicted in FIG. 26. In the event that a sitter detects a condition oran alarm that requires his individual attention to a patient, the sitternext actuates the ATTEND PATIENT button for that patient's room, forinstance one of ATTEND PATIENT buttons 2631 and 2632 (see 754). As aresult, sitter management service 352 invokes the rollover policies (see756) and the sitter is presented a sitter attend patient screen asdepicted in FIG. 27 for the patient receiving individual attention, inthis case patient room 302. Here, sitter management service 352 (orsitter manager app 354 commands sitter app 353) clears the sitter device360 of all patient room surveillance frames other than the patientdesignated by the sitter for individual attention, see room surveillanceframe 2702 displayed on sitter device 360 in FIG. 27. The sitter attendpatient screen displays an enhanced surveillance video of the attendedpatient in surveillance frames 2601, exemplary patient vital signs box2760 and patient tools, in the present case the sole LEAVE button 2782for notifying sitter management service 352 that the sitter is leavingthe individual attention of the patient in room 302.

With further regard to sitter management service 352 at 756, the sittersremaining patients are temporarily rollover assigned between availablesitters. Those patients are automatically presented in the postassignment sitter main patient monitoring screens of the rolloverassigned sitters. See for example FIG. 29, where a sitter has beenassigned patient rooms 400 and 404 and presented surveillance videos inroom surveillance frames 2900 and 2904, and corresponding ATTEND buttons2930 and 2934, and where the rollover policies of sitter managementservice 352 issue rollover alert 2912 to alert the sitter that patientroom 301 has been temporarily rollover assigned to him. With alert 2941,is presented surveillance frame 2901 and ATTEND button 2931 for therollover assignment for monitoring the rollover assigned patient. Notethat sitter management service 352 attempts to keep sitter loadingapproximately equivalent to all sitters (equally distribute the patientsamong sitters), so that if the attending sitter had been assigned otherpatients, those patients would most likely be temporarily rolloverassigned to over available sitters. Note also that sitter managementservice 352 alerts the sitter's manager of the rollover. The sittermanager may then, in response, monitor the rollover policies andprogress at any of sitter manager screens, or take other manuallyinvoked action as the sitter manager deems appropriate for thesituation.

Once the sitter's attending tasks are completed with regards to anindividual patient (or the sitter is relieved in the patient's room byan HCF professional), the sitter leaves the patient's room and returnsto his assigned station for continuing his sitter tasks. Typically, thesitter notifies sitter management service 352 he is available byclicking LEAVE button 2782 (shown on FIG. 27, see also 758) and inresponse sitter management service 352 deactivates the rollover policies(see 760). Alternatively, LEAVE button 2882 may be presented as a solechoice in a sitter patient attend screen as depicted in FIG. 28, see 762or as an acknowledgement function the sitter selecting LEAVE button 2782shown on FIG. 27.

In any case, in response to receiving the LEAVE command from a sitter,sitter management service 352 rescinds the rollover assignments. Thesitter is then presented with the surveillance videos for each of hisoriginally assigned patient rooms in his post assignment sitter mainpatient monitoring screen, such as illustrated in FIG. 26 or FIG. 29(assuming the sitter also has a temporary rollover patient assignment ofhis own). The sitter manager may verify that the rollover policies havebeen deactivated or the present state of the rollover by merelyaccessing a post assignment sitter main patient monitoring screen forone of the affected sitters, see 760. The sitter then returns to hispatient monitoring duties, see 764.

Finally, it should be appreciated that the sitter must remain alertduring the entire extent of his patient monitoring shift. If thesitter's attention wanes, then patients may be in jeopardy. Sitteralertness is tested in several ways (see 770 and FIG. 32), first by thesitter manager merely monitoring a surveillance video of the sittertaken by sitter device 360, see sitter surveillance frame 1452 in FIG.14. Alternatively, for more interactive sitter response, the sittermanage may initiate a sitter chat with a sitter to inquire on thecondition of a particular sitter, see SITTER CHAT button 1456 in FIG.14. However the drawback of either of these options s that the sittermanager must be manually involved in the alertness test. Alternativelythen, sitter management service 352 may issue an automated alertnesstest to any or all of the sitters logged in (see 770). In response,sitter management service 352 issues a sitter alertness in the form ofexemplary alertness test screen bar 3255 (see FIG. 32), with sitteralertness response button 3251 (see 770). Subsequent to sittermanagement service 352 issuing a sitter alertness test, the sitter isallowed an appropriate time period for interacting with sitter alertnessresponse button 3251. If sitter management service 352 receives anacknowledgement response from the sitter (see 772), the alertness testis complete. If not, sitter management service 352 must take remedialaction, such as altering the sitter's manager, an HCF professional(s) incharge of the patients assigned to the sitter and/or considering theinattentive sitter as being unavailable for his patient monitoringduties and invoking the rollover policies (see 780). In the event thatthe sitter does not acknowledge the alertness test, the sitter managermay, manually, invoke another alertness test, initiate a sitter chat orsome combination of the two prior to manually invoking the rolloverassignment policies for the sitter's assigned patients.

With regard to the deployment, distribution and assignment of sitterswithin an HCF, sitters should be matched to patients based on thepatients' sitter requirements or needs, and the sitters should bedeployed about a facility based on achieving an adequate sitter responsetime to the sitter's assigned patients. Sitter-patient should beapproximately equivalent for sitter-patient groups and should be themaximum sitter response times between sitter managed patient groups(referred to hereinafter synonymously as sitter groups). Ideally, eachsitter managed patient group should have approximately the same numberof patients and the maximum distance between the sitter and farthest twopatients in a sitter group should also be approximately equal (thisassumes that the locations of sitters' patient monitoring stations isnot stationary (or fixed), but floating based on the locations of thepatients rooms). The aim of the presently described electronic patientsitter management system and method is not to find a particular vantagepoint to view patient doors, but it is intended to find the most optimallocation of a sitter's patient monitoring station in order to reduce thetime it takes for the sitter to reach the sitter's patients (in someoptimum locations for sitter patient monitoring stations, the sitter'spatient room doors might not even be visible). The concept of sitteroptimal deployment and distribution for reducing sitter response time isrepresented diagrammatically in FIGS. 5, 6A and 6B.

FIG. 5 is a topological view of HCF 500 including patient rooms 400, HCFstations 450A, 4504B and 4504C, ICU 506 and corridors 508. Superimposedon HCF 500 are data transmission network 210, including patient roomvideo surveillance cameras/set top boxes 202 (only representativeelements are labeled to reduce clutter within the figure). Alsosuperimposed on HCF 500 is the presently described exemplaryimplementation of the electronic patient sitter management system andmethod for implementing in accordance with various exemplary embodimentsof the present invention. For the purposes of discussion, the exemplaryelectronic patient sitter management system illustrated herein includesfour separate sitter managed (monitor) patient groups, designated groups1, 2, 3 and 4. Group 1 encompasses the sitter patients within ICU 506and is monitored by sitter device 561, which is positioned within ICU506. A second sitter managed patient group, Group 2, is monitored bysitter device 562, which is positioned in the corridor in the upper leftof HCF 500. The sitter controlling sitter device 562 is responsible formonitoring three patient rooms, each designated with a “2,” andsurrounding the position of sitter device 562 represented in the figure.Likewise, Group 3, is monitored by sitter device 563, which isresponsible for monitoring the three other patient rooms designated witha “3,” and Group 4, is monitored by sitter device 564, which isresponsible for monitoring the two patient rooms designated with a “4.”In this example, the monitoring station locations of each sitter anddevice (with the exception of ICU) are flexible and currently located incorridor positions in an HCF. Alternatively, the monitoring stationlocations could be fixed or stationary with the sitters could bestationed within the HCF with predetermined HCF department rooms, suchas at the closest of HCF stations 450A, 450B and 450C, in an emptypatient room 400 or within the most centrally located patient room ofthe sitter's monitor group. Prior art local sitter systems placed asitter in the room of a patient assigned to the sitter. One advantage ofthe presently described electronic patient sitter management system andmethod is that the location of sitter monitoring stations may beanywhere within the HCF, keeping sitters out of patient rooms issometimes advantageous, but not always necessary.

With regard to rollover condition and policies, one major shortcoming ofthe prior art sitter systems was its inflexibility to changing in thesitters that are unavailable for performing sitter duties. If a sittergoes on break, lunch or is otherwise unavailable, the usual response ofthe prior art local sitter is to replace the sitter with a HCFprofessional until the sitter becomes available for his duties, oranother sitter could be made available for monitoring the first sitter'spatient. While covering for unavailable sitters might seem to be arather random and non-repeating condition, even a medium sized HCF,eight or ten patients might require sitter services in addition to theICU. As a practical matter, eight sitter patients might require thatmore than one flex sitter be staffed for replacing sitters for ordinaryand scheduled breaks, lunches and personal time. If more than one sitterbecomes simultaneously unavailable, the prior art local sitter systemwas prone to failure and placing patients in jeopardy of not beingmonitored due to sitter staffing.

For the purposes of describing the present invention, whenever a sitterthat has been assigned a patient is not available to monitor thatpatient, a “rollover condition” exists because that sitter's patientassignment must be rolled over to other sitters or HCF professionals. Inthe prior art local sitter system where a sitter is assigned to andpositioned adjacent to each patient needing sitter services, a flexsitter is constantly moving from patient room to patient room, thus, theprior art local sitter system is constantly in some state of rollover,with regard to at least one patient. However, sitters in the presentlydescribed electronic patient sitter management system are responsiblefor monitoring multiple patients simultaneously and their monitoringstation is not located in a room of most of their patients (at best thesitter monitoring station is located in only a single patient room).Therefore, when a patient needs individual attention from a sitter, thatsitter is unavailable to monitor the remaining patients in the sitter'spatient management group. This creates an even more critical conditionthan the prior art since multiple patients are likely not beingmonitored if a sitter is unavailable. Consequently, rollover policiesshould be implemented, within the electronic patient sitter managementsystem, that are immediately and automatically invoked whenever a sitterbecomes unavailable to monitor patients. Optimally, the rollover policyimplemented should be best suited for the particular HCF implementingthe policy, maintaining equal patient distribution and/or sitter/patientratios (sitter loading), the layout of the HCF, the number of patientsneeding sitting services and the number of sitter patients havingspecial needs, and the like. Implementation of a temporary patientassignment rollover is described below with regard to the description ofthe sitter rollover mode method described in FIGS. 9A and 9B inaccordance with an exemplary embodiment of the present invention.

An exemplary rollover condition is an attempt by the describedelectronic patient sitter management system to distribute patients froman unavailable sitter, either to another sitter or some other entity.Typically, a particular rollover policy to be invoked (or at least agroup of candidate rollover policies) is selected in advance, dependingon objectives, layout and policies of the HCF, needs of the sitterpatients and the scale of the sitter operation, one or more of thefollowing rollover policies can be used.

“Blast” is a rollover policy where the remaining patients from asitter's monitoring group are reassigned to all other sitters that arecurrently available, that is those that are actively monitoringpatients. When the electronic patient sitter management system invokesthe Blast rollover policy, rollover patients can appear in multipledevices depending on the number of available sitters. Once the sitterdenotes they are leaving the single patient interaction mode on thesitters' device, the previously distributed rollover assigned patientsreturn to the original sitter and are removed from the other sitters'sitter devices. The Blast rollover policy is extremely advantageous forhandling short term and regular rollover events such as handling sitterbreaks.

“Round Robin Distribution” is a rollover policy where the remainingpatients are distributed to the other sitters using a round robin untilthey are completely distributed to other available sitters. Once thesitter denotes they are leaving the single patient interaction, thepreviously distributed rollover patients return to the original sitterand are removed from the others.

“Equal Distribution” is a rollover policy where the remaining patientsare equally distributed to other sitters, taking into account how manypatients each of the sitters are already monitoring. Sitters with theleast number of patients receive the rollover patients, attempting tokeep the same number of patients per sitter. Once the sitter denotesthey are leaving the single patient interaction, the previouslydistributed rollover patients return to the original sitter and areremoved from the others.

“Blueprint” is a rollover policy where the patients are sent to othersitters within a specific range based on the hospital blueprint. Morespecifically, this policy uses the distance from one patient room toanother, in conjunction with what sitters are assigned to patients inthose rooms, to determine which sitters should be close enough to handlethe patients that are rolled over. The Blueprint rollover policy is veryadvantageous in keeping sitter response times below a threshold level ofadequacy. Once the sitter denotes they are leaving the single patientinteraction, the previously distributed rollover patients return to theoriginal sitter and are removed from the others.

“Wi-Fi Proximity” rollover policy is where the patients are sent toother sitters within a specific range based on what wireless accesspoint their device is connected to. It checks for other sitters usingthe same or nearby wireless access point to deduce sitters that areclose enough to handle the patients that are rolled over. Once thesitter denotes they are leaving the single patient interaction, thepreviously distributed rollover patients return to the original sitterand are removed from the others.

“GPS” rollover policy is where the patients are sent to other sittersbased on proximity using the device's GPS. This policy accounts forlatitude, longitude, and altitude in order to discern the location andfloor of sitters that are close enough to handle the patients that arerolled over. Once the sitter denotes they are leaving the single patientinteraction, the previously distributed rollover patients return to theoriginal sitter and are removed from the others.

“No Rollover” is a policy where the remaining patients are not rolledover to anyone. In effect, the other patients that were being monitoredsimply go unmonitored during the period that their sitter is unavailablefor sitter monitoring duties. Obviously, this policy is the leastdesirable of the rollover policies, but in some cases is necessary. TheNo Rollover policy is often the result of all other rollover policiesfailing under the circumstance, such as when multiple sitters aresimultaneously interacting with separate single patients.

It should be mentioned that under certain circumstances, especiallyunder Wi-Fi Proximity and GPS rollover policies, a sitter may berequired to reposition to better serve the patients being monitored. Inother situations, one or more of a sitter's patients may be reassignedto other sitters in order to effectively implement the rollover policiesand balance the sitter's loads with patient's closest to the sitter'sinitial monitoring group.

FIGS. 6A and 6B graphically represent the redistribution of patientsfrom one sitter group to another sitter group based on a sitter becomingunavailable, such as when a sitter issues an ATTEND PATIENT command forinteracting with a single patient. FIG. 6A shows HCF 600 with thepresently described electronic patient sitter management systemimplementing therein in an initial patient assignment state (or somestate), subsequent to patients being assigned to sitters andsitter/patient groups being defined as described above with regard tothe flowchart depicted in FIGS. 8A and 8B. HCF 600 is identical to HCF500 in that four separate sitter managed groups are defined with Group 1encompassing the patients within ICU and is monitored by sitter device661, Group 2 being monitored by sitter device 662 that is positioned inthe corridor centrally located to the patient rooms of Group 2,likewise, groups 3 and 4. FIG. 6B shows the new patient/sitter groupswith sitter device 663 becoming unavailable by providing personalinteraction with a single patient (labeled “3”). In response, thepresently described electronic patient sitter management system invokesits predetermined rollover policies for the event. Here, HCF 600 showsthe resultant patient distribution subsequent to the Equal Distributionrollover policy for redistributing patients equally between sitters 662and 664 with regard to distance using one of the WI-FI, GPS or Blueprintrollover policies. Notice one patient from Group 3 is assigned to eachof Groups 2 and 4, while both sitters 662 and 664 relocate theirpositions based on some distance criteria.

As a sidebar it should be noted that in some cases, all of a sitter'spatients are reassigned to other available sitters, such as when asitter is determined to be inattentive to the sitter's assignedpatients, or when the sitter fails the alertness test. Surveillance canbe brutally boring causing the sitter's attention to turn from themonitoring screen. If undetected, the patient may be in jeopardy. Inaccordance with one exemplary embodiment of the present invention thepresently described electronic patient sitter management system detectsinattentive sitters by issuing random alertness tests. The alertnesstest prompts the sitter to respond at random intervals. The test can beas simple as a dialog box prompting the sitter to push a button. If thesitter fails to pass the test, the incident is logged and reported to aremote station. Depending on the severity, frequency and history of thesitter, failing the alertness may cause the electronic patient sittermanagement system to list the sitter as unavailable, de-authorize thesitter's device and invoke a rollover policy, automatically.Alternately, or in addition, the sitter device may contain a motion andor position sensor that evaluates the position and orientation of thedevice and logs changes that indicate that the sitter device has beenmoved. If the device remains stationary over a long period of time, theelectronic patient sitter management system may issue an alertness test,or issue tests more frequently. Moreover, the sitter device may also beconfigured with video (webcam). From that, a sitter manager can monitorreal time video from the device. It is not expected that the sitter willalso be in the view angle of the camera, but will from time to time,allowing the manager a glimpse of the sitter.

FIGS. 8A, 8B, 9A, 9B, 10A and 10B are flowcharts depicting variousmethods performed by the presently described electronic patient sittermanagement system. FIGS. 8A and 8B depict a flowchart for a method forsetting sitter distributions and sitter assignments within theelectronic patient sitter management system in accordance with oneexemplary embodiment of the present invention. As a practical matter,the patients (or patient rooms) are actually assigned to the sitters,however, for ease of describing the present invention, the sitterassignments will be understood as being synonymous to patient sitterassignment or patient assignments. The method of FIGS. 8A and 8B is mostoften accomplished at shift changes, but may be invoked at anytime.Optimally, this process is automated within sitter management service352, but might instead be manually executed by a sitter manager, forinstance.

The sitter distribution and assignment process begins by assessing thenumber of patients needing sitter services (step 802) and then proceedsby identifying each patient and locations of the corresponding patientrooms (this is only necessary if one of Wi-Fi Proximity, GPS and/orBlueprint rollover policies will be used, as well as for distributingthe sitter stations over the HCF) (step 804). Additionally, if a patienthas special sitter needs or sitter requirements, each patient's specialsitter needs should also be identified. These special sitterrequirements are usually based on some patient welfare criteria, such asthose patients requiring a sitter with advanced first aid or CPRtraining. Alternatively, certain patients may indicate a genderpreference for the sitters who are responsible for them. Next, thesitter manager and/or sitter management service 352 identifies theavailable sitters, each sitter's special skills and training and theirgender (step 806). In some HCFs, such as a long term care orrehabilitation facilities, certain sitters may be issued specializedequipment, such as heart defibrillators, vital signs monitors,resuscitators, aspirators or the like. Those sitters and their equipmentshould also be identified for the distribution and patient assignmentprocess.

Next, the sitters are assigned patients in a two pass sitterdistribution and assignment method, the first pass by correlating thosepatients with special sitter requirements to sitters having those skillor who are assigned specialty equipment for meeting that patient'sneeds. The second pass is for assigning the sitters to all remainingpatients without regard to a sitter's skills or assigned equipment.Optimally, it is expected that the assignment of sitters to patientswill be accomplished automatically by sitter management service 352,however, certain patient assignment criteria may be beyond the scope ofthe sitter management service, requiring the sitter manager to makesitter assignments manually to the patients. Initially, the sitterassignment process tests for unassigned patients (step 808) and thentests for patients with special sitter needs (step 810). If patientswith special needs are identified as being unassigned to sitters, eachpatient with a special need is correlated to a sitter possessing askill, training, gender or equipment matching that special patientsitter requirement (step 812). Then, sitters with special skillsmatching the patients' sitter requirements receive patient assignments(step 814) (see FIGS. 9A and 9B below).

Patient sitter assignments is essentially identical for patients havingspecial sitters needs and for those without any special sitter needs,however, it is expected that most patients needing sitter services willusually not have any special sitter requirements. The sitter assignmentsub-process is depicted in FIG. 8B and identical for both passes.Initially, the sitter assignment sub-process assesses the number ofsitters that should be available for the patient's needing sitterservices, the first pass for only those patients with special sitterrequirements (step 826). Here, the available sitters have already beenidentified in step 804 so this step merely confirms to the sittermanager that the sitter staff is adequate to handle the number ofpatients needing sitter services. Patients are then grouped by sitter,into sitter groups. Optimally, this sitter grouping attempts to keep thepatient to sitter ratio approximately equal for all of the availablesitters (step 828). Here, it should be mentioned that maintainingpatient/sitter ratios is difficult for patients with special sitterrequirements because the sitter requirements vary widely betweenpatients as do the sitters' skills and assigned equipment. Additionally,sitters may have designated fixed monitoring stations, such as at anurse station or the like, or may have floating stations that aredetermined based on, for example, the locations of the patient's roomsin the sitter's group, i.e., the sitter's assigned patients. In thefirst instance, patients are grouped to sitters having fixed monitoringstations that are proximately located to the locations of the patients'room. In the second instance, patients may be assigned to a sitter groupbased on their proximity to each other's room locations (step 830) andonly then are the sitters' floating station locations determined withinthe HCF. In the latter case, the locations of a sitter's floatingmonitoring station will be determined based on distances betweenfurthest located patient rooms in a group, usually the midpoint betweenthose patient rooms.

Next, the sitter assignment sub-process tests the sitter response timesfor patient room locations within a sitter's patient group (step 832).The aim is to not only have the sitter/patient ratio between sittersbeing approximately equivalent, but also the maximum response times forsitters to be equivalent between sitter groups, or at least maintain theresponse time being below a base response time for each patient. If thesitter response times are adequate, the patients in a group are assignedto the respective sitter groups, or more particularly to a sitter'swireless sitter device 360 for that sitter group, and each sitter isdesignated a location for establishing a patient monitoring station fromwhich to monitor patients (step 834). The sitter sub-process thenreverts to the test for unassigned patients at step 808.

If, however, at step 832, the sitter response time for one or all of thepatients is not adequate between the sitter groups, the sitterassignment sub-process attempts to correct this deficiency byredistributing the sitters to the patients, thus forming new sittergroups, ideally with adequate sitter response times. The sitter groupsare shuffled (usually only once (step 836)) to find a better combinationof sitter and patients within the sitter groups (step 838) and thesitter assignment sub-process reverts to step 830 for determininglocation the sitter monitoring stations (assuming the stations havefloating, and not fixed patient monitoring locations) and again teststhe sitter response times for adequacy (step 832). If the response timesare adequate, the sitter sub-process then reverts to testing forunassigned patients at step 808, if the response times are not, theprocess moves to the shuffle count test at step 836. If the maximumnumber of sitter shuffles have already occurred, then the processinquires as to the availability of one or more additional sitters (step838). If another sitter can be identified, that sitter is added to thesitter distribution and assignment process (step 840) and the processthen reverts to step 804 where all sitters and their special skills,assigned equipment and gender are identified. If an additional sitter isadded for the first pass of the sitter distribution and assignmentprocess, that sitter should have the skills or training necessary neededto satisfy steps 812 and 814 of the process (merely adding a sitterwithout any skills/training matching the patients' requirements will notalter the outcome of the sitter response time test in step 832. Theprocess then continues as describe above, hopefully with adequate sitterresponse times. If, however, at step 838, no other sitters can beidentified for assignments, then the sitter assignment sub-processproceeds to step 834 where each of the sitters are assigned patients (towireless sitter devices 360) regardless of sitter response adequacy, andeach sitter is designated a patient monitoring stations from which tomonitor patients (if necessary). In the last case, the HCF mustcompromise its established adequacy goals for sitter response times.

Once all sitters with special skill, training or equipment are assignedto patients having matching sitter requirements, then the processreverts to the sitter assignment test for unassigned patients at step808. At this point, only patients without special sitters needs are notassigned to sitters (steps 808, 810 and 816), however all sitters, eventhose with special training, skills and assigned equipment, andregardless of gender, are consider for additional sitter assignments ofpatients. In the second pass of the sitter assignment sub-process, thenumber of sitters that are needed for sitter services in, for example,the HCF, is determined for any remaining patients that are not assignedto sitter (those patients without special sitter requirements) (step826). Patients are again grouped by sitter with an attempt to keep thepatient to sitter ratio approximately equal for all of the sitter groups(step 828). Because some of the sitters have already been assignedpatients (those with special sitter requirements), sitters not havingspecial skills, training or assigned equipment will receive most of thenew patient assignments.

Next, the locations of the sitters' monitoring stations are determined(step 830), sitter response times tested for adequacy (step 832) and thesitter assigned patients based on a positive outcome of the responsetime test (step 834). The process then reverts to the sitter assignmenttest at step 808 and ends.

If, at step 832, the sitter response time for the patients is notadequate, the patient assignment tests for previous sitter groupshuffling (step 836), shuffles the sitter groups if possible and againdetermines the sitter monitoring locations (step 830) and tests forresponse times for adequacy (step 832). Here, if the response times areadequate, the sitter sub-process then reverts to the test for unassignedpatients at step 808, and the process ends as all patients are assignedto sitters.

If, at step 832 the sitter response times are not adequate, the processmoves to inquire for another sitter to be added. If an additional sitteris available and can be added (step 840), the process reverts to step804 where all sitters are identified and the process continues asdescribed above with the additional sitter. If no other sitters areavailable, then the sitter assignment sub-process proceeds to step 834where each of the patients are assigned to the sitters (to wirelesssitter devices 360) regardless of response adequacy, and each sitter isdesignated a location for a patient monitoring station from which tomonitor patients (if necessary). The process then tests for unassignedpatients needing sitter services (step 808), and ends as all patients,those with special sitter requirements and those without any specialsitter requirements, are all assigned to appropriate sitters.

FIGS. 9A and 9B is a flowchart of a method performed by the electronicpatient sitter management system arbitrating between standard run modeand rollover conditions in accordance with one exemplary embodiment ofthe present invention. As mentioned above, the presently describedelectronic patient sitter management system is superior to the prior artlocal sitter paradigm, among other reasons, because the system canadjust by reassigning patients between sitters for available sitters.While at first blush, rollover events may seem to be random andinfrequent, actually, the electronic patient sitter management system ispredicated on rolling over patients from one sitter to others. Ensuringthat the system acquires the correct mode is paramount.

The process begins by defining initial sitter groups based on the numberof patients needing sitter services and the special sitter requirementsof some of those patients (step 902). Next, sitter groups are definedfor the HCF based on those groups for monitoring patients' rooms (step904). The rollover policy(ies) that the HCF intends to invoke isselected from those discussed above, or a hybrid rollover policy, orprimary and secondary policies to be conditionally invoked (step 908).Exemplary rollover policies are discussed above. Next, the sitters areauthorized on electronic patient sitter management system and the sitterdevices enabled (step 906). Patient sitters assignments, structuringsitter groups and authorizing sitters and their devices are describedabove with regard to the flowchart depicting in FIGS. 8A and 8B and withregard to block 710 in FIG. 7A. The steps described above are typicallyperformed while the electronic patient sitter management system is inset up mode, however at this point the electronic patient sittermanagement system transitions into run or monitoring operation mode.

Once the rollover policy(ies) are identified for the HCF, the systemproceeds into an infinite loop of testing for unavailable sitters andinvoking temporary rollover assignments based on the outcome of thattest. At each iteration, the process verifies that all authenticatedsitters that were available for performing their sitter monitoringduties in the previous iteration are still available in the currentiteration (step 910). As discussed elsewhere above, a sitter may becomeunavailable to one or all of his assigned patients for a variety ofreasons: the sitter is attending an individual patient and isunavailable to the remaining assigned patients; the sitter is on breakand is unavailable to all of his assigned patients; the sitter fails analertness test and is unavailable to all of his assigned patients, etc.If, at step 910, a previously available sitter becomes unavailable, theprocess flows directly to step 920 for invoking a rollover policy.Invocation of rollover assignment policy(ies) is described below in FIG.9B.

Returning to step 910, assuming all sitters that were available in theprevious iteration are currently available, the system checks forrollover policies that might currently be in effect for the currentiteration (step 912). Here it should be apparent that in any iteration,the electronic patient sitter management system may or may not becurrently operating in a rollover mode with the associated rolloverpolicies in effect. If a rollover policy is not currently invoked inthis iteration, the process tests for a new rollover condition (step916). Briefly returning to step 912, if a rollover policy is in effect,the process flows to step 914 where the system tests for rolloverconditions that precipitated the policy, that is, if the previouslyunavailable sitter remains unavailable. If the condition has not abated,the process continues to step 916 and the process tests for a newrollover condition, that is, if all previously available sitters remainavailable. Here, the rollover process iterates between steps 912, 914and 916, testing for a rollover policy, testing for the previouslyunavailable sitters becoming available and vice versa. i.e., testing forrollover conditions that caused the current rollover policy to beinvoked and testing for any new rollover conditions that might have beendetected this iteration.

The process continues iterating between steps 912, 914 and 916 unlessone of two events are detected, a previously unavailable sitter becomingavailable in step 914 or a previously available sitter becomesunavailable at step 916. When a previously unavailable sitter becomesavailable, that is the rollover condition abates (step 914), the processrescinds the current rollover policy (step 918) and returns to step 908where the returning sitter and sitter device is enabled/authorized andthe rollover tests continue at step 912. If, on the other hand, apreviously available becomes unavailable, that is a new rollovercondition is detected, the process invokes a rollover policy (step 920).

Turning to FIG. 9B rollover sitter assignment is a two pass sub-processthat essentially mirrors the sitter assignments passes described abovein FIGS. 8A and 8B for patients having special sitter requirements andpatient without any special sitter needs. The rollover process beginswith the process to gather information concerning the rollover conditionfrom either of steps 910 or 916 (step 952). A rollover condition mightinvolve the system receiving sitter “attend patient” request command forthe sitter designating an assigned patient to receive individualattention, or sitter logout request command indicating that a sitterwill be unavailable to monitor any of the sitter's assigned patients,the system may receive an indication that a sitter failed an alertnesstest failure, also indicating that the sitter unavailable for monitoringany of the sitter's assigned patients. With that information, theprocess identifies all patients that are unmonitored in the currentiteration of the process (step 954). Those patients are then deletedfrom the sitter's assigned patients (assuming the sitter remainsavailable for at least one assigned patient (step 956).

Next, the process flows into the two passes for temporarily rolloverassigning patients that have special sitter requirements, and for thosepatients not having special sitter requirements, beginning with a testfor patients having special sitter requirements (step 958). Assumingsuch patients are being unmonitored, the process identifies thoseunmonitored patients, along with their special sitter requirements (step968). Next, the process identifies any available sitters with specialskills, training or assigned equipment matching the patients' specialsitter requirements (step 970).

Here it should be understood that sitter assignment matching forpatients having special sitter needs may not always be completelysuccessful, especially in the case of a sitter having specialskill/training/equipment becoming unavailable. In some cases, no sittermatch is present and the patient with special sitter needs remainsunassigned in the first pass. Optimally, a patient is rollover assignedto an available sitter having a matching skill/training/equipment, ifone exists, but if more than one exists, the process invokes therollover policies to determine which sitter to assign. Although theflowchart is not clear in this area, the sitters having specialskill/training/equipment are matched to patients have matching sitterrequirements in a parallel process flow, one parallel pipe for eachunique special sitter requirement. Some parallelrequirement-skill/training/equipment pipes might have one patient andseveral sitters correlating to a match, otherrequirement-skill/training/equipment pipes may have only one sitter andseveral patients, while still other requirement-skill/training/equipmentmay have only a single sitter and a single patient. The process handlesthese parallel operations for each patient sitter requirement bydetermining the number of sitters having a specialskill/training/equipment matching the sitter requirement (step 972) andthen calling up the rollover policy(ies) designated in step 906 for thecase where more than a single sitter matches (step 964) and then assignsthe patient(s) with special sitter requirements to a plurality ofavailable sitters having matching special skill/training/equipment basedon the rollover policy(ies) (step 966). If at step 972, only a singleavailable sitter exists, the process assigns the patient with specialsitter requirements to the only available sitter having matching specialskill/training/equipment (step 966). Next, the process tests for anyunassigned and unmonitored patients in the current pass (step 968).Recall here that some patients with special sitter needs may not bematched to sitters having a corresponding specialskill/training/equipment and so those patients are rollover assigned inthe second pass for the remainder (if any) of the unassigned andunmonitored patients.

The process returns to step 960 for identifying any available sitter(s)in this iteration of the process. It should be appreciated that theavailable sitter(s) may be one or any available sitter(s) without anyspecial skill/training/equipment, and/or available sitter(s) havingspecial skill/training/equipment but no temporary rollover assignedpatients from the first pass, and/or available sitter(s) having specialskill/training/equipment with one or more temporary rollover assignedpatient(s) from the first pass. In this pass, the designation of anavailable sitter having special skill/training/equipment is notconsidered. As in the first pass, if at step 962, only a singleavailable sitter exists, the unmonitored patient(s) are assigned to thatavailable sitter for monitoring (step 966). Alternatively, if more thanone sitter is currently available at step 962, then the processretrieves the proper designated rollover policy(ies) for the rollovercondition (step 964) and assigns the patients to the sitters based onthat designated rollover policy(ies) (step 966). The process then makesa final test for unmonitored patients in this iteration of the process,subsequent to the second pass there should be no unmonitored patients,and the process returns to step 922. The process essentially continuesrunning in the background until, for instance, the sitters' work shiftend, the sitters log out en masse and the presently described electronicpatient sitter management system authorizes new sitter under the processof FIGS. 8A and 8B.

FIGS. 10A and 10B depict a flowchart of method performed by theelectronic patient sitter management system for logging events andissuing alerts and rollover policy in accordance with exemplaryembodiments of the present invention. Before proceeding with thedescription of the method, the presently described electronic patientsitter management system documents log events differently depending onthe type of event. Essentially, the sitter system logs identities ofsitter, the sitter device, the event type, the time the event occurredand patient (if the event is patient driven), regardless of the type ofevent. Additionally, the system logs the event duration and/or sitterresponse time for alerts and alarms. Optionally, the system may log thelocation of sitter device, if the location information is known. Inaccordance with some exemplary embodiments of the present invention, thesystem will log frequency and duration of non-emergency interactionsbetween the sitter and staff, mostly for quality assurance of thesitter's capabilities (see for instance sitter activity log 1430 on FIG.14). Finally, in situations where the event might be important for thepatient's medical records, or in cases where some aspect of the eventmight need further review, the system may save the event with thesurveillance video data for the patient and/or to the patient's records.

The present process is iterative and continuous, regardless of theoperational mode, i.e., set up, RUN, patient monitoring, in or out ofrollover, etc. While the steps below are described as “checks,” morepragmatically the system merely resides in a WAIT state for theoccurrence of an event and then determines the applicability of loggingthe event based on the method criteria below. One test, perhaps aforerunner test, is for sitter log ins or log outs (step 1002). If asitter logs in, the process goes to step 1008 where the log in event islogged. If, on the other hand, a sitter log out is detected, that sitterbecomes unavailable for monitoring and a rollover policy is invoked(step 1016). The process reverts to step 1008 where the event is logged.

Subsequent to logging, the system may perform an optional movement test(step 1004) and if the sitter device is moving or has moved, the systemdetermines if the device has been moved out of the sitter's designatedmonitoring area (step 1004). If so, the system issues an alert to, forexample, the sitter manager, apprising her of the movement (step 1006).The process reverts to step 1008 where the movement event is logged. Ifthe sitter device has not moved (step 1004) or has not moved outside thesitter monitor area (step 1010), the process checks for the occurrencesitter alert tests (step 1012). If an alert test has occurred and thesitter responds appropriately (passes the test), the test event islogged (step 1008) and the process reverts to, for example, step 1002and continues.

If, on the other hand, the sitter fails the alertness test, the systemmay take one of two responses. First, the system might merely issue analert to the sitter manager (step 1006) and log the test failure (step1008). Alternatively, the system may instead treat the sitter as beingunavailable for monitoring and invoke the appropriate rollover policy(step 1016). In that case, the system logs both the test failure and therollover event (step 1008). Ideally, the system should not immediatelytreat the sitter as being unavailable unless some factors other than asingle alertness test failure are present, e.g., the sitter manager setthe rollover parameters, the sitter failed multiple successive alertnesstests, etc.

Next, if the system receives information from a sitter device that thesitter is interacting with a single patient, and hence unavailable formonitoring the sitter's remaining patients, the system invokes therollover policy (step 1016) and then logs receiving of the patientinteraction information and the rollover event itself (step 1008).Receiving information that a sitter has invoked some other rolloverpolicy is handled similarly to single patient interaction events. Thesystem invokes the specified rollover policy (step 1016) and then logsboth the receiving event and the rollover event (step 1008). Finally,most, if not all, sitter interactions with the sitter device are logged(step 1008) and the process iterates to step 1002.

As will be appreciated by one of skill in the art, the present inventionmay be embodied as a method, system, or computer program product.Accordingly, the present invention may take the form of an entirelyhardware embodiment, an entirely software embodiment (includingfirmware, resident software, micro-code, etc.) or an embodimentcombining software and hardware aspects all generally referred to hereinas a “circuit” or “module.” Furthermore, the present invention may takethe form of a computer program product on a computer-usable storagemedium having computer-usable program code embodied in the medium.

Any suitable computer readable medium may be utilized. Thecomputer-usable or computer-readable medium may be, for example but notlimited to, an electronic, magnetic, optical, electromagnetic, infrared,or semiconductor system, apparatus, device, or propagation medium. Morespecific examples (a nonexhaustive list) of the computer-readable mediumwould include the following: an electrical connection having one or morewires, a portable computer diskette, a hard disk, a random access memory(RAM), a read-only memory (ROM), an erasable programmable read-onlymemory (EPROM or Flash memory), an optical fiber, a portable compactdisc read-only memory (CD-ROM), an optical storage device, atransmission media such as those supporting the Internet or an intranet,or a magnetic storage device. Note that the computer-usable orcomputer-readable medium could even be paper or another suitable mediumupon which the program is printed, as the program can be electronicallycaptured, via, for instance, optical scanning of the paper or othermedium, then compiled, interpreted, or otherwise processed in a suitablemanner, if necessary, and then stored in a computer memory. In thecontext of this document, a computer-usable or computer-readable mediummay be any medium that can contain, store, communicate, propagate, ortransport the program for use by or in connection with the in theinstruction execution system, apparatus, or device. The computer-usablemedium may include a propagated data signal with the computer-usableprogram code embodied therewith, either in baseband or as part of acarrier wave. The computer usable program code may be transmitted usingany appropriate medium, including but not limited to the Internet,wireline, optical fiber cable, RF, etc.

Moreover, the computer readable medium may include a carrier wave or acarrier signal as may be transmitted by a computer server includinginternets, extranets, intranets, world wide web, ftp location or otherservice that may broadcast, unicast or otherwise communicate anembodiment of the present invention. The various embodiments of thepresent invention may be stored together or distributed, eitherspatially or temporally across one or more devices.

The exemplary embodiments described below were selected and described inorder to best explain the principles of the invention and the practicalapplication, and to enable others of ordinary skill in the art tounderstand the invention for various embodiments with variousmodifications as are suited to the particular use contemplated. Theparticular embodiments described below are in no way intended to limitthe scope of the present invention as it may be practiced in a varietyof variations and environments without departing from the scope andintent of the invention. Thus, the present invention is not intended tobe limited to the embodiment shown, but is to be accorded the widestscope consistent with the principles and features described herein.

The flowchart and block diagrams in the Figures illustrate thearchitecture, functionality, and operation of possible implementationsof systems, methods and computer program products according to variousembodiments of the present invention. In this regard, each block in theflowchart or block diagrams may represent a module, segment, or portionof code, which comprises one or more executable instructions forimplementing the specified logical function(s). It should also be notedthat, in some alternative implementations, the functions noted in theblock may occur out of the order noted in the figures. For example, twoblocks shown in succession may, in fact, be executed substantiallyconcurrently, or the blocks may sometimes be executed in the reverseorder, depending upon the functionality involved. It will also be notedthat each block of the block diagrams and/or flowchart illustration, andcombinations of blocks in the block diagrams and/or flowchartillustration, can be implemented by special purpose hardware-basedsystems which perform the specified functions or acts, or combinationsof special purpose hardware and computer instructions.

The terminology used herein is for the purpose of describing particularembodiments only and is not intended to be limiting of the invention. Asused herein, the singular forms “a”, “an” and “the” are intended toinclude the plural forms as well, unless the context clearly indicatesotherwise. It will be further understood that the terms “comprises”and/or “comprising,” when used in this specification, specify thepresence of stated features, integers, steps, operations, elements,and/or components, but do not preclude the presence or addition of oneor more other features, integers, steps, operations, elements,components, and/or groups thereof.

What is claimed is:
 1. A method for managing patient surveillance videoin an electronic sitter system for monitoring patients, the methodcomprising: receiving, at a first sitter device, a plurality ofreal-time patient surveillance video streams from cameras located in aplurality of patient rooms, wherein the first sitter device receives theplurality of real-time patient surveillance video streams regardless ofwhether an alert is received by the first sitter device; simultaneouslydisplaying the plurality of real-time patient surveillance video streamsat the first sitter device; detecting, by a motion detector device,patient motions within a given one of the plurality of real-time patientsurveillance video streams; discriminating, by the motion detectordevice, from the patient motions one or more movements that areindicative of a potential fall; receiving an alert corresponding to theone or more movements that are indicative of a potential fall at thefirst sitter device, wherein the alert is received subsequent to thefirst sitter device receiving the given real-time patient surveillancevideo stream; providing at least one interactive control for at least agiven one of the plurality of patient rooms that corresponds to thegiven real-time patient surveillance video stream, wherein theinteractive control is selected from the group consisting of an attendpatient control and a nurse call control; and transmitting a signal to astaff calling system based on a selection from the at least oneinteractive control.
 2. The method of claim 1, wherein the interactivecontrol includes a patient chat function between the first sitter deviceand the plurality of patient room.
 3. The method of claim 1 wherein theanalysis of the given real-time patient surveillance video streamfurther comprises prioritizing video frames of the given real-timepatient surveillance video stream based on content or external factors.4. The method of claim 1 wherein the analysis further comprises labelingvideo frames of the given real-time patient surveillance video stream asdocumentation for a patient medical procedure.
 5. The method of claim 4further comprising compiling medical procedure information screens basedon the labeled video frames for display on the first sitter device. 6.The method of claim 1 further comprising communicating with a medicalprocedure sensing device that senses an event indicative of acommencement of a patient medical procedure.
 7. The method of claim 1wherein the alert includes an indication that emphasizes a roomsurveillance frame corresponding to the given patient room.
 8. Themethod of claim 1 wherein the analysis further comprises predicting apatient fall based on the one or more movements.
 9. The method of claim1 further comprising logging events or actions of a patientcorresponding to the given patient room.
 10. The method of claim 1further comprising receiving vital sign data from a plurality of sensorsfor capturing data in the given patient room.
 11. An electronic sittersystem coupled to a patient surveillance network, the patientsurveillance network comprising a plurality of video cameras forcapturing and transmitting surveillance video streams and a plurality ofsensors for capturing data in patient rooms, each of the plurality ofvideo cameras located in a patient room and aimed at an interior of therespective patient room, the electronic sitter system comprising: aplurality of sitter devices, each sitter device configured to: receive aplurality of real-time patient surveillance video streams from cameraslocated in a plurality of patient rooms, wherein the sitter devicereceives the plurality of real-time patient surveillance video streamsregardless of whether an alert is received by the sitter device;simultaneously display the plurality of real-time patient surveillancevideo streams; receive an identification of one or more movements thatare indicative of a potential fall based on a motion detector devicedetecting and discriminating patient motions within a given one of theplurality of real-time patient surveillance video streams; receive analert corresponding to the one or more movements that are indicative ofa potential fall, wherein the alert is received subsequent to the sitterdevice receiving the given real-time patient surveillance video stream;provide at least one interactive control for at least a given one of theplurality of patient rooms that corresponds to the given real-timepatient surveillance video stream, wherein the interactive control isselected from the group consisting of an attend patient control and anurse call control; and transmit a signal to a staff calling systembased on a selection from the at least one interactive control.
 12. Anelectronic sitter system for managing patient surveillance video in anelectronic sitter system for monitoring patients, the electronic sittersystem comprising: a monitoring and control device configured to:receive a plurality of real-time patient surveillance video streams fromcameras located in a plurality of patient rooms; transmit the pluralityof real-time patient surveillance video streams to a sitter device,wherein the plurality of real-time patient surveillance video streamsare transmitted to and simultaneously displayed at the sitter deviceregardless of whether an alert is transmitted to the sitter device; anda motion detector device configured to: detect patient motions within agiven one of the plurality of real-time patient surveillance videostreams; discriminate from the patient motions one or more movementsthat are indicative of a potential fall; and transmit an alert to thesitter device, wherein the alert is triggered by the one or moremovements that are indicative of a potential fall and wherein the alertis transmitted subsequent to transmitting the given real-time patientsurveillance video stream to the sitter device.
 13. The electronicsitter system of claim 12 wherein the monitoring and control devicecomprises a video processor configured to: detect the patient motions byanalyzing the given real-time patient surveillance video stream; andprioritize video frames of the given real-time patient surveillancevideo stream based on content or external factors.
 14. The electronicsitter system of claim 12 wherein the monitoring and control devicecomprises a video processor configured to label video frames of theplurality of real-time patient surveillance video streams asdocumentation for a patient medical procedure.
 15. The electronic sittersystem of claim 14 wherein the monitoring and control device comprises avideo processor configured to compile medical procedure informationscreens based on the labeled video frames for display on the sitterdevice.
 16. The electronic sitter system of claim 12 further comprisingthe monitoring and control device configured to communicate with amedical procedure sensing device that senses an event indicative of acommencement of a patient medical procedure.
 17. The electronic sittersystem of claim 12 wherein the alert includes an indication thatemphasizes a room surveillance frame corresponding to a given one of theplurality of patient rooms that corresponds to the given real-timepatient surveillance video stream.
 18. The electronic sitter system ofclaim 12 further comprising the monitoring and control device configuredto predict a patient fall based on the one or more movements.
 19. Theelectronic sitter system of claim 12 further comprising a communicationsystem that includes a patient chat function between the sitter deviceand a given one of the plurality of patient rooms that corresponds tothe given real-time patient surveillance video stream.
 20. Theelectronic sitter system of claim 12 further comprising receiving vitalsign data from a plurality of sensors.